ECG AND BLOOD PRESSURE CHANGES DURING THE 6 HOURS PACLITAXEL INFUSION

The ECG and blood pressure changes during 6 hours paclitaxel infusion were evaluated in 33 cancer patients. A total of 141 cycles of paclitaxel was infused to 24 ovarian, 8 breast, and 1 lung cancer patients in 1000cc 5% dextrose solution. The standard premedication consisted of prednisolone and H1-2 antagonists was administered to all patients. Sixteen patients received 135 mg/sqm, 7 pts 150 mg/sqm and 10 pts 175 mg/sqm of paclitaxel. Twelve of the patients had been pretreated with anthracycline based combination chemotherapy. Pre and post infusion ECGs were recorded and hourly blood pressures and pulse rates were monitored during the infusion period. The ECGs were evaluated for the ischemic and arytmic changes during each and each other course. ECG changes were determined only in 4 (12%) patients and in 4 (3%) cycles. The changes were ST depression in two, ventricular premature beats in 1, asymptomatic bradycardia (<60/min) in 1. These 4 patients had not used anthracyclines previously but 2 of them had a history of cardiac disease. ECG changes were found to be significantly higher in patients with cardiac history (p<0.01). There was no correlation between the different doses administered and the ECG changes. No persistent ECG changes occured during the paclitaxel infusions. Although fluid was loaded, no significant change in blood pressures was recorded at the end of the infusion. Pulse rate decreased in 65% of the cycles during the therapy. In conclusion there is no need in ECG and blood pressure monitoring during paclitaxel infusion in patients with no history of cardiac disease.