Neurovascular Changes Induced by Chemotherapy
Condition: Breast Cancer; Chemotherapeutic Toxicity
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      The purpose of the present study was to test the hypothesis that doxorubicin and
      cyclophosphamide adjuvant chemotherapy (CHT) acutely induces neurovascular and hemodynamic
      changes in patients with breast cancer. To test this hypothesis, women with breast cancer
      (stage II-III) underwent two experimental sessions, saline (SL) and CHT. In the CHT session,
      doxorubicin (60 mg/m2) and cyclophosphamide (600mg/m2) were administred in 45 min. In the SL
      session, a matching saline volume to that of the CHT session was infused over 45 min.
    

Detailed description: 
      The purpose of the present study was to test the hypothesis that doxorubicin and
      cyclophosphamide adjuvant chemotherapy (CHT) acutely induces neurovascular and hemodynamic
      changes in patients with breast cancer. To test this hypothesis, the patients were submitted
      in two experimental sessions, saline and chemotherapy, respectively. Saline Session. After
      fasting for 2 hours and abstaining from caffeine for 24 hours, the patients were positioned
      in a supine position. An intra-venous catheter was placed into the brachial venous in the
      contralateral arm of the breast surgery. Microelectrodes were positioned for MSNA measures in
      right leg, cuffs were placed around the leg for blood flow assessments and finger cuff was
      placed in 3 finger of hand for measurement of hemodynamic variables. After the
      instrumentation, an interval of 10 minutes was allowed, followed by blood sample collections
      for measurement of MPEs and, hemodynamic and neurovascular measures by period of 15 minutes
      (pre-infusion). Then, dexamethasone 20 mg and ondansetron 8 mg were administered i.v.,
      followed by saline 0,09%, during 45 minutes. During saline infusion were continuously
      measured the neurovascular and hemodynamic variables. Finally, after saline administration,
      another blood sample was collected for MPEs dosing, followed by continuous measurement of
      hemodynamic and neurovacular variables by 15 minutes period (Figure 1).

      Chemotherapy session. After a 2 to 3 day-interval, the patients were again positioned in a
      supine position in a temperature-controlled room (22oC). An intra-venous catheter was placed
      into the brachial venous in the contralateral arm of the breast surgery. Then,
      microelectrodes were positioned in the contralateral leg of the first session for MSNA
      measures. Likewise, cuffs were placed around the contralateral leg of the first protocol for
      blood flow assessments. After the instrumentation, an interval of 10 minutes was allowed,
      followed by blood sample collections and basal hemodynamic and neurovascular measures. Then,
      dexamethasone 20 mg and ondansetron 8 mg were administered, i.v., followed by doxorubicin and
      cyclophosphamide, during 45 minutes. During doxorubicin and cyclophosphamide infusions were
      continuously measured the neurovascular and hemodynamic variables. Finally, after doxorubicin
      plus cyclophosphamide administration, another blood sample was collected for EMPs dosing,
      followed by continuous measurement of hemodynamic and neurovacular variables by 15 minutes
      period
    

Intervention name(s): Chemotherapy
Intervention type(s): Other
Intervention description(s): In chemoteraphy session, doxorubicin (60 mg/m2) and cyclophosphamide (600mg/m2) were administred in 45 min
Other intervention name(s): Doxorubicin and cyclophosphamide
Intervention MeSH terms: Cyclophosphamide; Doxorubicin
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: Chemotherapy; Muscle sympathetic nervous activity; Blood flow; Endothelial microparticles