BEVACIZUMAB-INDUCED ARTERIAL HYPERTENSION AS A ASPECT OF STUDYING CARDIOTOXICITY IN THE TREATMENT OF COLORECTAL CANCER


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Abstract

Purpose: to evaluate the dynamics of hemodynamic parameters of cardiotoxicity of targeted therapy of colorectal cancer with bevacizumab in complex therapy in the development of grade I-II AH.
Materials and methods. The study analyzed 58 case histories of patients who underwent complex therapy for colorectal cancer in the Ostroverkhov Regional Clinical Center. The study group took bevacizumab in addition to chemotherapy. The average age of the patients was 65.8±7.5 (from 51 to 80) years, the ratio of men and women was 68.42% and 31.58%. Stage III cancer was determined - 56.67%, stage IV - 30%, stage II - 13.33%. Variants of localization of colorectal cancer: 42.1% of patients - cancer of the rectum, sigmoid and colon - 26.32% of patients, anal canal - 5.26% of cancer patients. Prior to the start of chemotherapy, pathology of the cardiological profile in 94.73% of patients, in the structure of which AH accounted for 44.42% of the total number of diseases. 62.5% of patients had II degree of AH, I degree of AH was observed in 37.5% of the patients.
The parameters of the cardiovascular system were assessed: systolic and diastolic pressure (SBP and DBP) by the method of N.I. Korotkov and heart rate (HR) according to the main control points: before chemotherapy, after 1, 3 and 6 months from its start. The indicators are described with the calculation of the mean value (M) and standard deviation (SD) and subjected to evaluation by Student's t-test for dependent variables. Statistically significant differences were considered between the indicators at p <0.05.
Results. There is a significant maximum change in SBP after 3 months of treatment, regardless of the location of colorectal cancer (rectum - 160 ± 5.8; sigmoid colon - 165 ± 4.2; colon - 164 ± 3.9; anal canal - 164 ± 4.1 mm Hg), DBP (rectum - 105 ± 3.6; sigmoid colon - 102 ± 2.9; colon - 105 ± 4.1; anal canal - 108 ± 3.3 mm Hg) , heart rate (rectum - 104 ± 7.3; sigmoid colon - 94 ± 6.2; colon - 106 ± 5.8; anal canal - 98 ± 6.9 bpm) (p<0.05).
Conclusions. In the treatment of PCT + bevacizumab, cardiotoxicity was registered according to the type of bevacizumab-induced hypertension of I-II degree. It is of interest to develop treatment regimens for bevacizumab-induced hypertension.

Full Text

BEVACIZUMAB-INDUCED ARTERIAL HYPERTENSION AS A ASPECT OF STUDYING CARDIOTOXICITY IN THE TREATMENT OF COLORECTAL CANCER

Actuality. Diagnosis of bevacizumab-induced arterial hypertension (AH) is a clinical problem of oncocardiological profile due to the ambiguity of ongoing studies [1].

Objective: to evaluate the dynamics of hemodynamic parameters of cardiotoxicity of targeted therapy of colorectal cancer with bevacizumab in complex therapy in the development of grade I-II hypertension.

Materials and methods. The study analyzed 58 case histories of patients who underwent complex therapy for colorectal cancer in the Ostroverkhov Regional Clinical Center. The study group took bevacizumab in addition to chemotherapy. The average age of the patients was 65.8±7.5 (from 51 to 80) years, the ratio of men and women was 68.42% and 31.58%. Stage III cancer was determined - 56.67%, stage IV - 30%, stage II - 13.33%. Variants of localization of colorectal cancer: 42.1% of patients - cancer of the rectum, sigmoid and colon - 26.32% of patients, anal canal - 5.26% of cancer patients. Prior to the start of chemotherapy, pathology of the cardiological profile in 94.73% of patients, in the structure of which AH accounted for 44.42% of the total number of diseases. In 62.5% of patients, the II degree of AH was recorded, the I degree of AH was observed in 37.5% of the subjects. Korotkov and heart rate (HR) according to the main control points: before chemotherapy, after 1, 3 and 6 months from its start. The indicators are described with the calculation of the mean value (M) and standard deviation (SD) and subjected to evaluation by Student's t-test for dependent variables. Statistically significant differences were considered between the indicators at p <0.05.

Results. There is a significant maximum change in SBP after 3 months of treatment, regardless of the location of colorectal cancer (rectum - 160 ± 5.8; sigmoid colon - 165 ± 4.2; colon - 164 ± 3.9; anal canal - 164 ± 4.1 mm Hg), DBP (rectum - 105 ± 3.6; sigmoid colon - 102 ± 2.9; colon - 105 ± 4.1; anal canal - 108 ± 3.3 mm Hg) , heart rate (rectum - 104 ± 7.3; sigmoid colon - 94 ± 6.2; colon - 106 ± 5.8; anal canal - 98 ± 6.9 bpm) (p<0.05).

Conclusions. In the treatment of PCT + bevacizumab, cardiotoxicity was registered according to the type of bevacizumab-induced hypertension of I-II degree. It is of interest to develop treatment regimens for bevacizumab-induced hypertension.

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About the authors

Stanislav Valerievich Khlyamov

Kursk State Medical University

Author for correspondence.
Email: xavjelinell@yandex.ru

6th year student

Russian Federation, 305004, Russia, Kursk, K. Marx St., 3

Galina Sergeevna Mal

Kursk State Medical University

Email: mgalina.2013@mail.ru

Head of the Department of Pharmacology, Doctor of Medical Sciences, Professor

Russian Federation, 305004, Russia, Kursk, K. Marx St., 3

Elena Borisovna Artyushkova

Kursk State Medical University

Email: eartyushkova@mail.ru

Director of the Research Institute of Experimental Medicine, KSMU of the Ministry of Health of the Russian Federation, Doctor of Biological Sciences, Professor

Russian Federation, 305004, Russia, Kursk, K. Marx St., 3

References

  1. Кобалава, Ж.Д. Артериальная гипертония на фоне терапии онкологических заболеваний ингибиторами ангиогенеза: серьезное препятствие или управляемая реакция? / Ж.Д. Кобалава, Е.К. Шаварова // Опухоли головы и шеи. – 2017. – Т. 7, № 2. – С. 70-80.

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