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Annals of Oncology Advance Access originally published online on July 20, 2006
Annals of Oncology 2006 17(10):1586-1591; doi:10.1093/annonc/mdl156
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© 2006 European Society for Medical Oncology

sarcomas and melanoma

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

CAJ Brouwer1,*, JA Gietema2, MP van den Berg3, MTE Bink-Boelkens4, NJ Elzenga4, J Haaksma3, WA Kamps1, JM Vonk5, EGE de Vries2 and A Postma1

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

*Correspondence to: Dr C. A. J. Brouwer, University Medical Centre Groningen, University of Groningen, Department of Paediatrics, Division of Paediatric Oncology, PO Box 30 001, 9700 RB Groningen, The Netherlands. Tel: +31-503614213; Fax: +31-503611671; E-mail: c.a.j.brouwer{at}bkk.umcg.nl

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.

Key words: anthracyclines, bone tumour, cardiac toxicity, late effects, longitudinal


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