Decline in pulmonary function in patients with breast cancer receiving dose-dense chemotherapy: A prospective study

R. Yerushalmi*, M. R. Kramer, S. Rizel, A. Sulkes, K. Gelmon, T. Granot, V. Neiman, S. M. Stemmer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Prompted by complaints of dyspnea in breast cancer patients receiving adjuvant dose-dense chemotherapy (DDC), we sought to evaluate the possible association of DDC with pulmonary dysfunction. Patients and methods: A total of 34 consecutive patients receiving adjuvant DDC were enrolled. The chemotherapy regimen consisted of i.v. doxorubicin 60 mg/ m2 and cyclophosphamide 600 mg/m2 (AC) every 14 days ×4 with growth factor support followed by weekly i.v. paclitaxel 80 mg/m2 ×12. The following parameters were prospectively measured before and after the AC protocol (P1, P2) and at completion of paclitaxel treatment (P3): presence of dyspnea, blood pressure, pulse rate, hemoglobin, erythrocyte sedimentation rate, C-reactive protein level, cardiac ejection fraction, and pulmonary function. Repeated measures analysis was used to evaluate differences among the time points, and paired t -test was used to evaluate differences between consecutive time points. Results: Although only five patients (15%) complained of dyspnea, there was a significant decrease in mean carbon monoxide diffusing capacity (DLCO), in all patients from P1 (22.09 ml/min/mmHg) to P3 (15 ml/min/ mmHg) and in 29 of 32 patients (90.6%) from P1 to P2 (15.96 ml/min/mmHg) (P < 0.001). Conclusions: DDC is associated with a statistical significant reduction in DLCO. Awareness of this potential toxicity may be important in women with preexisting lung disease.

Original languageEnglish
Pages (from-to)437-440
Number of pages4
JournalAnnals of Oncology
Issue number3
StatePublished - 2009


  • Breast cancer
  • CRP pulmonary function
  • DLCO
  • Dose-dense chemotherapy
  • ESR


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