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Cochrane Database of Systematic Reviews

Different dosage schedules for reducing cardiotoxicity in people with cancer receiving anthracycline chemotherapy

Overview of attention for article published in Cochrane database of systematic reviews, March 2016
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Title
Different dosage schedules for reducing cardiotoxicity in people with cancer receiving anthracycline chemotherapy
Published in
Cochrane database of systematic reviews, March 2016
DOI 10.1002/14651858.cd005008.pub4
Pubmed ID
Authors

Elvira C van Dalen, Helena JH van der Pal, Leontien CM Kremer

Abstract

This review update has been managed by both the Childhood Cancer and Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Groups.The use of anthracycline chemotherapy is limited by the occurrence of cardiotoxicity. To prevent this cardiotoxicity, different anthracycline dosage schedules have been studied. To determine the occurrence of cardiotoxicity with the use of different anthracycline dosage schedules (that is peak doses and infusion durations) in people with cancer. We searched the databases of the Cochrane Register of Controlled Trials (CENTRAL) (the Cochrane Library, Issue 11, 2015), MEDLINE (1966 to December 2015), and EMBASE (1980 to December 2015). We also searched reference lists of relevant articles, conference proceedings, experts in the field, and ongoing trials databases. Randomised controlled trials (RCTs) in which different anthracycline dosage schedules were compared in people with cancer (children and adults). Two review authors independently performed the study selection, the 'Risk of bias' assessment, and data extraction. We performed analyses according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. We identified 11 studies: 7 evaluated different infusion durations (803 participants), and 4 evaluated different peak doses (5280 participants). Seven studies were RCTs addressing different anthracycline infusion durations; we identified long-term follow-up data for one of the trials in this update. The meta-analysis showed a statistically significant lower rate of clinical heart failure with an infusion duration of six hours or longer as compared to a shorter infusion duration (risk ratio (RR) 0.27; 95% confidence interval 0.09 to 0.81; 5 studies; 557 participants). The majority of participants included in these studies were adults with different solid tumours. For different anthracycline peak doses, we identified two RCTs addressing a doxorubicin peak dose of less than 60 mg/m(2) versus 60 mg/m(2) or more, one RCT addressing a liposomal doxorubicin peak dose of 25 mg/m(2) versus 50 mg/m(2), and one RCT addressing an epirubicin peak dose of 83 mg/m(2) versus 110 mg/m(2). A significant difference in the occurrence of clinical heart failure was identified in none of the studies. The participants included in these studies were adults with different solid tumours. High or unclear 'Risk of bias' issues were present in all studies. An anthracycline infusion duration of six hours or longer reduces the risk of clinical heart failure, and it seems to reduce the risk of subclinical cardiac damage. Since there is only a small amount of data for children and data obtained in adults cannot be extrapolated to children, different anthracycline infusion durations should be evaluated further in children.We identified no significant difference in the occurrence of clinical heart failure in participants treated with a doxorubicin peak dose of less than 60 mg/m(2) or 60 mg/m(2) or more. Only one RCT was available for the other identified peak doses, so we can make no definitive conclusions about the occurrence of cardiotoxicity. More high-quality research is needed, both in children and adults and in leukaemias and solid tumours.

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X Demographics

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 230 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
United States 1 <1%
Canada 1 <1%
Unknown 227 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 36 16%
Student > Bachelor 28 12%
Researcher 25 11%
Other 20 9%
Student > Ph. D. Student 16 7%
Other 41 18%
Unknown 64 28%
Readers by discipline Count As %
Medicine and Dentistry 88 38%
Pharmacology, Toxicology and Pharmaceutical Science 14 6%
Nursing and Health Professions 13 6%
Biochemistry, Genetics and Molecular Biology 13 6%
Psychology 6 3%
Other 22 10%
Unknown 74 32%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 January 2019.
All research outputs
#6,564,179
of 25,595,500 outputs
Outputs from Cochrane database of systematic reviews
#8,256
of 13,156 outputs
Outputs of similar age
#84,764
of 313,371 outputs
Outputs of similar age from Cochrane database of systematic reviews
#166
of 254 outputs
Altmetric has tracked 25,595,500 research outputs across all sources so far. This one has received more attention than most of these and is in the 74th percentile.
So far Altmetric has tracked 13,156 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 35.8. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 313,371 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.
We're also able to compare this research output to 254 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.