Key result
Late cardiac effects were observed in 53% of childhood cancer survivors, with the highest risk (73%) found in those treated between 1989 and 1998 with intensive multiagent chemotherapy.
Why the study?
Do specific childhood cancer treatments (anthracyclines, radiotherapy) increase the risk of late cardiac damage in long-term survivors?
Observational (n=211)
No
Do specific childhood cancer treatments (anthracyclines, radiotherapy) increase the risk of late cardiac damage in long-term survivors?
Long-term survivors of childhood cancer have a high prevalence of late cardiac damage (53%), with specific treatments like anthracyclines and irradiation driving distinct structural and functional abnormalities.
Answers are grounded in this paper and cite their sources.
Supports lifelong cardiac surveillance in childhood cancer survivors; extends observational data on era-specific risks but leaves causality and interventions open.
BACKGROUND: With improved childhood cancer cure rate, long term sequelae are becoming an important factor of quality of life. Signs of cardiovascular disease are frequently found in long term survivors of cancer. Cardiac damage may be related to irradiation and chemotherapy.We have evaluated simultaneous influence of a series of independent variables on the late cardiac damage in childhood cancer survivors in Slovenia and identified groups at the highest risk. METHODS: 211 long-term survivors of different childhood cancers, at least five years after treatment were included in the study. The evaluation included history, physical examination, electrocardiograpy, exercise testing and echocardiograpy. For analysis of risk factors, beside univariate analysis, multivariate classification tree analysis statistical method was used. RESULTS AND CONCLUSION: Patients treated latest, from 1989-98 are at highest risk for any injury to the heart (73%). Among those treated earlier are at the highest risk those with Hodgkin's disease treated with irradiation above 30 Gy and those treated for sarcoma. Among specific forms of injury, patients treated with radiation to the heart area are at highest risk of injury to the valves. Patients treated with large doses of anthracyclines or concomitantly with anthracyclines and alkylating agents are at highest risk of systolic function defect and enlarged heart chambers. Those treated with anthracyclines are at highest risk of diastolic function defect. The time period of the patient's treatment is emerged as an important risk factor for injury of the heart.
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Velensek et al. (2008) conducted an observational in Childhood cancer survivors (n=211). Childhood cancer treatment (anthracyclines and/or irradiation) vs. Differently treated or unexposed survivor subgroups was evaluated on Overall cardiac damage (any abnormality in structure and/or function of the heart). Late cardiac effects were observed in 53% of childhood cancer survivors, with the highest risk (73%) found in those treated between 1989 and 1998 with intensive multiagent chemotherapy.
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