Late cardiotoxicity after treatment for a malignant bone tumor

A Postma*, MTE BinkBoelkens, GCM BeaufortKrol, RAM Kengen, NJ Elzenga, MJM SchasfoortvanLeeuwen, WA Kamps, H. Schraffordt Koops

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

54 Citations (Scopus)

Abstract

Cardiac function was assessed in longterm survivors of malignant bone tumors who were treated according to Rosen's T-5 or T-10 protocol, both including doxorubicin. Thirty-one patients, ages 10-45 years (median age 17.8 years) were evaluated 2.3-14.1 years (median 8.9 years) following completion of treatment. Cumulative doses of doxorubicin were 225-550 mg/m(2) (median dose 360). The evaluation consisted of a history, physical examination, electrocardiogram (EGG), signal averaged EGG, 24-hour ambulatory ECC, echocardiography and radionuclide angiography. Eighteen of 31 (58%) patients showed cardiac toxicity, defined as having one or more of the following abnormalities: late potentials, complex ventricular arrhythmias, left ventricular dilatation, decreased shortening fraction, or decreased ejection fraction. The incidence of cardiac abnormalities increased with length of follow-up (P less than or equal to .05). No correlation could be demonstrated between cumulative dose of doxorubicin and cardiac status, except for heart rate variability. When adjusted to body surface area, the left ventricular posterior wall thickness (LVPW index) was decreased in all patients. The incidence of doxorubicin-induced cardiotoxicity is high and increases with follow-up, irrespective of cumulative dose. Life-long cardiac follow-up in these patients is warranted. The results of our study suggest that heart rate variability and LVPW index could be sensitive indicators for cardiotoxicity. (C) 1996 Wiley-Liss, Inc.

Original languageEnglish
Pages (from-to)230-237
Number of pages8
JournalMedical and Pediatric Oncology
Volume26
Issue number4
Publication statusPublished - Apr-1996

Keywords

  • anthracyclines
  • cardiotoxicity
  • long-term effects
  • CONGESTIVE HEART-FAILURE
  • VENTRICULAR LATE POTENTIALS
  • DOXORUBICIN THERAPY
  • OSTEOGENIC-SARCOMA
  • CHILDHOOD-CANCER
  • CHEMOTHERAPY
  • CARDIOMYOPATHY
  • ASSOCIATION
  • CHILDREN

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