Abstract
Due to the constant increase in morbidity and mortality, bladder cancer remains a pressing problem in modern medicine. Despite the success of chemotherapy, chemotherapy physicians around the world have been concerned about the safety of these drugs for many years. Doxorubicin has been used as an antitumor drug for more than 40 years in various hematological and solid malignancies, however, its toxic effects when administered intravenously to vital organs and organ systems, including the heart, require further research. The aim of our study was to evaluate the manifestations and progression of cardiotoxicity in patients with bladder cancer with systemic and intravesical administration of doxorubicin. The study included 96 patients who were divided into three groups: the first group or the control group – patients who had a confirmed diagnosis of first stage bladder cancer, were treated surgically and did not receive doxorubicin; the second group – patients who, in addition to surgical treatment, received doxorubicin systemically (intravenously) in a therapeutic dose; the third group – patients who received doxorubicin at a dose of 50 mg, locally, by instillation of the drug into the bladder cavity, after prior catheterization with an elastic catheter. ECG data and biochemical markers of myocardial destruction before and after chemotherapy were studied. The study found that systemic serial administration of doxorubicin to patients with bladder cancer causes significant changes in the myocardium after the first course of chemotherapy. A single intravesical instillation of doxorubicin does not cause changes in laboratory and instrumental heart rate.
Highlights
Due to the constant increase in morbidity and mortality, bladder cancer remains a pressing problem in modern medicine
Our studies showed that the first group of patients who received only surgical treatment and did not receive doxorubicin, no anamnestic, laboratory or instrumental data that would indicate cardiovascular disorders were found
The use of doxorubicin has shown excellent results in the treatment of malignant tumors, but its wider use is hampered by its potential cardiotoxicity, which is clinically manifested by cardiomyopathy and congestive heart failure [6, 11, 17]
Summary
Due to the constant increase in morbidity and mortality, bladder cancer remains a pressing problem in modern medicine. Bladder cancer is the fourth most common cancer in the United States and Europe. This pathology ranks seventh and eighth in the structure of mortality from oncopathology in the United States [14] and Europe, respectively [4]. Tumors of the bladder occur 3-4 times more often in men than in women [14]. The overall five-year survival rate in Europe is about 68 % [2]. The situation in Ukraine is not better. Almost 5,000 new cases and more than 2,000 deaths from this pathology are registered annually [9]
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