Total anthracycline dose was the most important predictor of worsening cardiac performance, with patients receiving <240 mg/m2 showing no deterioration of left ventricular end systolic stress at >10 years.
Cohort (n=284)
Does cumulative anthracycline dose predict progression of cardiac dysfunction in childhood cancer survivors?
Cumulative anthracycline doses < 240 mg/m2 are associated with no significant deterioration in left ventricular end systolic stress at >10 years post-treatment in childhood cancer survivors.
BACKGROUND: The objective of the current study was to examine the risk factors for progression in severity of anthracycline-induced cardiac dysfunction, thereby providing information that is useful in refining cancer treatment regimes and guiding follow-up. METHODS: Serial echocardiograms were performed on 101 acute lymphoblastic leukemia survivors and 83 Wilms tumor survivors after a mean interval of 6.2 years and 6.7 years since last anthracycline dose, respectively, at first study, and after 10.3 years and 11.1 years, respectively, at second study. The paired data were contrasted with data from 100 normal subjects, and potential correlations with follow-up interval, cumulative dose, cancer diagnosis, gender, age at diagnosis, and growth were explored using univariate and multiple regression techniques. RESULTS: The most important predictor of worsening cardiac performance was total anthracycline dose. As a group, patients receiving 10 years from the end of treatment. CONCLUSIONS: Survivors who have received low-dose anthracycline require cardiac surveillance infrequently. In good prognosis tumors, cumulative anthracycline dose should be maintained at < 250 mg/m(2).
Sørensen 等（周二）对儿童癌症幸存者（急性淋巴细胞白血病和Wilms肿瘤）进行了队列研究（n=284）。评估了蒽环类药物与正常受试者在蒽环类药物诱导的心脏功能障碍严重程度（左心室末收缩压）的进展方面的差异。总蒽环类药物剂量是心脏性能恶化的最重要预测因子，接受<240 mg/m2治疗的患者在>10年后未见左心室末收缩压的恶化.