Continuous doxorubicin infusion for children offered no advantage over bolus infusion in terms of avoiding a weakening of the heart muscle. Lipshultzs team found that both types of infusion were associated with progressive heart disease. We dont think continuous infusion for children should be used if the primary reason is to reduce possible heart damage, Lipshultz says. We saw no sign that damage to the heart was minimized in any way.
Lipshultz, one of the worlds leading pediatric cardiology researchers, has been studying and publishing about the long-term effects of chemotherapy on children for 20 years. This was the first randomized, controlled, multi-center study created specifically to learn how we can protect childrens hearts from chemotherapy, he says. What we found was that continuous infusion didnt offer the heart protection that many in the medical community have assumed it did for more than 15 years.
There might be significant benefits to reverting to the bolus form of infusion. Although we didnt look at these factors in any formal way, continuous infusion appears to be associated with increased hospitalizations, higher medical costs, and an increased stress on these children, Lipshultz says. The effects of increased hospitalization on the patients quality of life and psychological well-being are important to consider.
Financially, the savings from eliminating continuous treatment would be substantial. Lipshultz says there are about 7,000 new cases of childhood cancer each year, about half treated with doxorubicin-type drugs, which are used to treat many forms of cancer. In the study, children receiving continuous infusions required at least 24 days in the hospital that children receiving the shorter infusions did not need. At an average cost of $2,000 per day for hospitalization, the tab for continuous-inf
Contact: Travis Anderson
University of Rochester Medical Center