The role of radionuclide angiocardiography in the treatment of patients receiving doxorubicin-based chemotherapy: a reassessment.

We attempted to evaluate the role of radionuclide angiography in the routine treatment of patients receiving doxorubicin-based therapy in a university hospital setting. We identified 222 cancer patients treated with doxorubicin or who underwent radionuclide angiography with the intent to receive doxorubicin at the University of Iowa in 1989. We examined the cumulative doses of doxorubicin, results of radionuclide angiograms, cardiac risk factors, and clinical outcomes and survival of patients. Of 222 patients, 168 (76%) underwent at least one radionuclide angiogram and received doxorubicin. Only a baseline study was performed in 136 (81%) of these 168 patients. Only 32 underwent follow-up study during therapy; six patients discontinued therapy for an 11-21% decrease in left ventricular function. The mean dose of doxorubicin received was 211 mg/m2, and 193 patients (96%) received a cumulative dose <450 mg/m2. Only two patients (1%) had heart failure. A questionnaire sent to medical oncologists in Iowa showed that use of radionuclide angiography in our institution reflected practice throughout the state. The majority of patients in our population who underwent radionuclide angiography had a single baseline study, which provides little clinically useful information. The majority of patients receiving doxorubicin as currently employed can be safely treated without radionuclide angiography.