Objective  This study aims to compare the effects and determine the clinical significance of a single dose of dexrazoxane or Shen Mai injection and the combined use of Shen Mai injection and dexrazoxane on multiple anthracycline cardiotoxicity in patients with hematological malignancies. This study also aims to explore better alternatives for reducing anthracycline cardiotoxicity.

  Methods  In this study, 120 patients were randomly divided into 4 groups with 30 cases per group. The Chinese medicine group (namely, the Shen Mai group or group A) received chemotherapy through a single-agent Shen Mai injection of 50 mL at the start of each week of treatment. Group B corresponded to the group treated with dexrazoxane and adriamycin at a dosage of 10: 1 via a fast intravenous drip (non-anthracycline drug adriamycin outperforms adriamycin under the same conditions) 30 min prior to the application of anthracycline chemotherapy drugs. Chemotherapy was done once a week with 50 mL of Shen Mai injection administered prior to the chemotherapy session. Group C corresponded to the Western medicine group, which only received dexrazoxane. The anthracene ring class drug was administered 30 min before each chemotherapy session. Groups A, B, and C were the experimental groups, whereas group D was designated as the blank control group. All groups received two complete cycles of chemotherapy. The ECG changes, echocardiography (left ventricular ejection fraction, LVEF), and B-type brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) values of all groups were observed before and after chemotherapy.

  Results  Upon comparing the ECG changes, LVEF, and cTnI and BNP values of the four groups before and after chemotherapy, we observed that the experimental group had lesser incidence rates of abnormal ECG and significantly decreased LVEF and cTnI and BNP values compared with the control group (P < 0.05).

  Conclusion  All of the treatments studied in this paper were effective in preventing chemotherapy-induced cardiotoxicity in cancer patients receiving anthracycline. The combination of Shen Mai injection and dexrazoxane produced the best effect, and dexrazoxane had a better protective effect on myocardial cells than the Shen Mai injection. In anthracycline chemotherapy, the combination of Shen Mai injection and dexrazoxane is expected to reduce cardiotoxicity better and, therefore, worthy of clinical application.