Testing for Doxorubicin Cardiotoxicity

To the Editor: The February 8 issue of the Journal contained an article by Alexander et al.¹ and an editorial by Henderson and Frei² on the cardiotoxicity of doxorubicin. Both the article and the editorial concluded that sensitive measurements of myocardial function could be used as criteria for discontinuation of doxorubicin treatment. We do agree that even low doses of doxorubicin can produce changes in myocardial function, as shown previously by Friedman et al.,³ Stein et al.⁴ and our own unpublished results. At doses of about 200 mg per square meter, we found changes in myocardial function in five of.