Protective effects of Panax ginseng against doxorubicin-induced cardiac toxicity in patients with nonmetastaticbreast cancer: a randomized, double blind, placebo controlled clinical trial

Anthracycline-based chemotherapy increases the riskof cardiotoxicity in breast cancer patients. Thisprospective study evaluated the beneficial role ofginseng supplementation in alleviating doxorubicininducedcardiotoxicity besides declining leftventricular ejection fraction (LVEF) in breast cancerpatients.Thirty women with non-metastatic, HER-۲ negativeearly breast cancer were enrolled into the study.Participants received ginseng (۱ g/day) or placebo inconjugation with standard anticancer therapy.Echocardiographic measurements were assessed atbaseline, after the final cycle of anthracycline therapy(۴th cycle), and at ۶ months of chemotherapy (۸thcycle). High-sensitive cardiac troponin I (hs-cTnI)was assessed at baseline and after the ۴th cycle.Cardiotoxicity was defined as a drop in LVEF of ≥۱۰% from baseline in patients whose LVEF was ≥۵۰%.A significant difference in LVEF changes wereobserved from baseline to the ۴th cycle (-۱.۳ ± ۱.۱%vs. -۵.۲۷ ± ۰.۸%, p-value = ۰.۰۰۶) and from baselineto the ۸th cycle (۰.۸ ± ۱.۳% vs. -۷.۳ ± ۱.۴%, p-value <۰.۰۰۱) between ginseng and placebo groups,respectively. None of the patients in the ginsenggroup developed cardiotoxicity during the studyperiod. In contrast, ۱(۶.۷%, p-value = ۰.۵) and ۵(۳۳.۳%, p-value = ۰.۰۲) patients in the placebo groupdeveloped cardiotoxicity after the ۴th and ۸th cycles,respectively. No significant difference was foundregarding hs-cTnI levels between the ۲ groups.

Keywords:

Breast Neoplasms , Anthracyclines , Cardiotoxicity , Panax ginseng