The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment).
A Cochrane review on cardioprotective agents in preventing heart damage in cancer patients treated with anthracyclines included 10 studies on dexrazoxane, with a total of 1619 subjects. Meta-analysis showed a statistically significant benefit in favour of dexrazoxane for the occurrence of heart failure (RR 0.29, 95% CI 0.20 to 0.41). No statistically significant difference in response rate between the dexrazoxane and control group was found (RR = 0.89, 95% CI 0.78 to 1.02). Only for one adverse effect (abnormal white blood cell count at nadir) a difference in favour of the control group was identified. There was no significant difference in response rate or survival between the dexrazoxane and control group. Individual studies on other cardioprotective agents (N-acetylcysteine; phenetylamines; coenzyme Q10; combination of vitamin E, vitamin C and N-acetylcysteine) showed no cardioprotective effect.