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Annals of Oncology Advance Access published online on July 20, 2006
Annals of Oncology, doi:10.1093/annonc/mdl156
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© 2006 European Society for Medical Oncology
Received March 13, 2006
Revised May 23, 2006
Accepted May 23, 2006

original article

Long-term cardiac follow-up in survivors of a malignant bone tumour

C. A. J. Brouwer 1 *, J. A. Gietema 2, M. P. van den Berg 3, M. T. E. Bink-Boelkens 4, N. J. Elzenga 4, J. Haaksma 3, W. A. Kamps 1, J. M. Vonk 5, E. G. E. de Vries 2, and A. Postma 1

1 Subdivision Paediatric Oncology, University Medical Centre Groningen, University of Groningen
2 Department of Medical Oncology, University Medical Centre Groningen, University of Groningen
3 Department of Cardiology, University Medical Centre Groningen, University of Groningen
4 Subdivision Paediatric Cardiology, University Medical Centre Groningen, University of Groningen
5 Department of Epidemiology, University Medical Centre Groningen, University of Groningen

* To whom correspondence should be addressed.
C. A. J. Brouwer, E-mail: c.a.j.brouwer{at}bkk.umcg.nl


  Abstract

Background: Longitudinal studies of cardiac function in long-term childhood cancer survivors are scarce and frequently concern a median follow-up shorter than 13 years.

Patients and methods: Cardiac assessment was performed in 22 doxorubicin-treated long-term survivors of a malignant bone tumour at median 22 years (range 15-27.5) post-treatment. Age at follow-up was 39 years (range 27-59) and cumulative dose of doxorubicin was 360 mg/m2 (range 225-550). Cardiac function was assessed by echocardiography and (24-h) ECG. The results were compared with those of earlier assessments at 9 years (1992) and 14 years (1997) post-treatment.

Results: Systolic dysfunction was found in 27% (9% in 1997; P = 0.02) and diastolic dysfunction in 45% (18% in 1997; P = 0.02). Heart rate variability showed further deterioration compared with earlier results.

Conclusions: Twenty-two years after doxorubicin-treatment, bone tumour survivors showed progressive cardiac dysfunction.

Keywords: anthracyclines; bone tumour; cardiac toxicity; late effects; longitudinal.
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