An Evaluation of Hepatotoxicity in Breast Cancer Patients Receiving Injection Doxorubicin

Abstract

Background: Hepatic dysfunction in the cancer unit has a significant impact on patient outcomes. The therapeutic application of anthracycline antibiotics are limited by side‑effects mainly myelosuppression, chronic cardiotoxicity, and hepatotoxicity. Aim: To assess the risk of Hepatotoxicity in breast cancer patients receiving Inj. Doxorubicin. Subjects and Methods: The investigation was a prospective study that was conducted in cancer patients receiving Inj. Doxorubicin doses of 50 mg/m2, and 75 mg/m2 at a South Indian tertiary care hospital. Sample collection was carried out from pre‑chemotherapy to 4th cycle. Serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), direct bilirubin and total bilirubin were assessed to determine hepatotoxicity. Data were analyzed using unpaired t‑test, Pearson correlation using Graph‑Pad Prism version 5.00 for Windows, Graph‑Pad Software, San Diego, California, USA, www.graphpad.com. Results: Breast cancer patients comprised 37% (49/132) of the total female cancer patient population, of which 46 patients with a mean age of 46.6 (13.4) years were included and 30.4% (14/46) patients were developed hepatotoxicity. The mean standard deviation of SGOT, SGPT, direct bilirubin, total bilirubin in the pre‑chemotherapy cycle to fourth chemotherapy cycle were found to be 21.97 (5.798) U/L and 181.3 (103.6) U/L, 23.17 (6.237) U/L and 147.6 (90.9) U/L, 0.1351 (0.1186) mg/dL and 0.5445 (0.4587) mg/dL, 0.3094 (1.346) mg/dL and 2.7163 (1.898) mg/dL simultaneously where P < 0.05 which were statistically significant. Conclusion: There exist a strong correlation between the use of Inj. Doxorubicin and risk for developing hepatotoxicity. The health‑care professionals dealing with breast cancer patients need to have awareness for hepatotoxicity with the use of Inj. Doxorubicin therapy.

Keywords: Breast cancer, Doxorubicin, Hepatotoxicity, Patient outcomes, South India