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Cited by 320

The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.

High Risk of Symptomatic Cardiac Events in Childhood Cancer Survivors

Open access
van der Pal, Helena J., van Dalen, Elvira C., van Delden, Evelien, van Dijk, Irma W., Kok, Wouter E., Geskus, Ronald B., Sieswerda, Elske, Oldenburger, Foppe, Koning, Caro C., van Leeuwen, Flora E., Caron, Huib N., Kremer, Leontien C.·2012·Journal of Clinical Oncology
DOI 10.1200/jco.2010.33.4730
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Abstract

Purpose: To evaluate the long-term risk for validated symptomatic cardiac events (CEs) and associated risk factors in childhood cancer survivors (CCSs). Patients and Methods: We determined CEs grade 3 or higher: congestive heart failure (CHF), cardiac ischemia, valvular disease, arrhythmia and/or pericarditis (according to Common Terminology Criteria for Adverse Events [CTCAE], version 3.0) in a hospital-based cohort of 1,362 5-year CCSs diagnosed between 1966 and 1996. We calculated both marginal and cause-specific cumulative incidence of CEs and cause-specific cumulative incidence of separate events. We analyzed different risk factors in multivariable Cox regression models. Results: Overall, 50 CEs, including 27 cases of CHF, were observed in 42 survivors (at a median attained age of 27.1 years). The 30-year cause-specific cumulative incidence of CEs was significantly increased after treatment with both anthracyclines and cardiac irradiation (12.6%; 95% CI, 4.3% to 20.3%), after anthracyclines (7.3%; 95% CI, 3.8% to 10.7%), and after cardiac irradiation (4.0%; 95% CI, 0.5% to 7.4%) compared with other treatments. In the proportional hazards analyses, anthracycline (dose), cardiac irradiation (dose), combination of these treatments, and congenital heart disease were significantly associated with developing a CE. We demonstrated an exponential relationship between the cumulative anthracycline dose, cardiac irradiation dose, and risk of CE. Conclusion: CCSs have a high risk of developing symptomatic CEs at an early age. The most common CE was CHF. Survivors treated with both anthracyclines and radiotherapy have the highest risk; after 30 years, one in eight will develop severe heart disease. The use of potentially cardiotoxic treatments should be reconsidered for high-risk groups, and frequent follow-up for high-risk survivors is needed.

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Metadata

Authors
van der Pal, H. J., van Dalen, E. C., van Delden, E., van Dijk, I. W., Kok, W. E., Geskus, R. B., Sieswerda, E., Oldenburger, F., Koning, C. C., van Leeuwen, F. E., Caron, H. N., & Kremer, L. C.
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2012-05-01
Volume
30
Issue
13
Pages
1429-1437
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.2010.33.4730
OpenAlex
W2154505306
Cited by
320
References
35
FWCI
18.22
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: High Risk of Symptomatic Cardiac Events in Childhood Cancer Survivors. https://app.cochat.ai/papers/10.1200/jco.2010.33.4730
The paper
van der Pal, H. J., van Dalen, E. C., van Delden, E., van Dijk, I. W., Kok, W. E., Geskus, R. B., Sieswerda, E., Oldenburger, F., Koning, C. C., van Leeuwen, F. E., Caron, H. N., & Kremer, L. C. (2012). High Risk of Symptomatic Cardiac Events in Childhood Cancer Survivors. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2010.33.4730

Data sources

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.