# 一名乳癌個案即將開始doxorubicin化療。第一劑前必須完成哪一項基線評估？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391862&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名乳癌個案即將開始doxorubicin化療。第一劑前必須完成哪一項基線評估？

## 選項

1. 以基線心臟超音波或MUGA掃描評估LVEF；doxorubicin會造成劑量相關的累積性心毒性 **✔ 正確答案**
2. 骨密度檢查
3. 肺功能檢查
4. 子宮頸癌篩檢

**正確答案: 1**

## 解析

正確（2）：Doxorubicin和其他anthracycline會造成劑量相關累積性心肌病變；終身劑量通常限制在450-550 mg/m²以下。需以echo或MUGA取得基線LVEF並定期監測。高劑量療程可用dexrazoxane保護心臟；紅色尿液通常無害，但也要注意強烈vesicant風險。（1、3、4）與anthracycline心臟安全無關。

## 深入解析

記憶提示 Anthracycline是紅色藥、紅色尿，也是心臟紅燈。Dexrazoxane是心臟保護劑，終身劑量上限很關鍵。

## 臨床情境

情境 52歲女性第三期乳癌，開始doxorubicin療程。治療前評估。

## 重要概念

- **Doxorubicin（小紅莓/Adriamycin）** — Anthracycline；有累積性心毒性、vesicant風險與紅色尿液。
- **心毒性監測** — 治療前、治療中與治療後以echo/MUGA追蹤LVEF。
- **Dexrazoxane 心臟保護劑** — 高劑量anthracycline前使用，以降低心毒性。

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