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Related Experiment Videos

Cardiac function in Wilms' tumor survivors

K Sorensen1, G Levitt, D Sebag-Montefiore

  • 1Department of Haematology/Oncology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|July 1, 1995
PubMed
Summary

Anthracycline treatment in children with Wilms' tumor can lead to late cardiac dysfunction, specifically increased afterload, linked to cumulative dose and dose-intensity. Survivors without anthracyclines showed mild LV hypertrophy, potentially offering protection.

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Area of Science:

  • Pediatric Oncology
  • Cardiology
  • Cancer Survivorship

Background:

  • Wilms' tumor survivors have good long-term survival rates.
  • Late cardiac dysfunction is a potential concern in cancer survivors.
  • Anthracyclines, like doxorubicin, are used in chemotherapy but can have cardiotoxic effects.

Purpose of the Study:

  • To evaluate late cardiac function in pediatric Wilms' tumor survivors.
  • To compare cardiac function in patients treated with and without anthracyclines against a normal control group.
  • To identify risk factors associated with late cardiac dysfunction.

Main Methods:

  • Echocardiographic studies were conducted on 97 patients treated with anthracyclines, 39 without, and 50 normal subjects.
  • Evaluated left ventricular (LV) dimensions, end-systolic wall stress (afterload), and contractility.

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  • Multivariate analysis examined risk factors including cumulative anthracycline dose, dose-intensity, and treatment duration.

    • Main Results:

    • 25% of anthracycline-treated patients exhibited cardiac abnormalities, primarily increased LV afterload.
    • Anthracycline cumulative dose and dose-intensity were significant risk factors for increased afterload.
    • Wilms' tumor patients not treated with anthracyclines showed mild LV hypertrophy compared to controls.

    Conclusions:

    • Anthracycline total dose and dose-intensity are key risk factors for increased LV afterload in Wilms' tumor survivors.
    • Increased afterload, not impaired contractility, explained reduced LV shortening.
    • Pre-existing LV hypertrophy in non-anthracycline patients may offer protective effects against cardiotoxicity.