Coronary artery disease surveillance among childhood, adolescent and young adult cancer survivors: A systematic review and recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group.

Autor: van Dalen EC; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands., Mulder RL; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands., Suh E; Loyola University Chicago Health Sciences Division, Maywood, USA., Ehrhardt MJ; St. Jude Children's Research Hospital, Memphis, USA., Aune GJ; Greehey Children's Cancer Research Institute, University of Texas Health Science Center San Antonio, San Antonio, USA., Bardi E; Kepler University Clinic, Department of Pediatrics, Division of Pediatric Hemato-Oncology, Linz, Austria; St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria., Benson BJ; University of Minnesota Medical School, Minneapolis, USA., Bergler-Klein J; Department of Cardiology, Medical University of Vienna, Vienna, Austria., Chen MH; Boston Children's Hospital/Dana Farber Cancer Institute, Department of Cardiology, Harvard Medical School, Boston, USA., Frey E; St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria., Hennewig U; University Hospital of Giessen and Marburg, Pediatric Hematology and Oncology, Giessen, Germany., Lockwood L; Children's Health Queensland Hospital and Health Service, South Brisbane, Australia., Martinsson U; Department of Genetics, Immunology and Pathology, Section of Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden., Muraca M; IRCCS Istituto Giannina Gaslini, Genova, Italy., van der Pal H; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands., Plummer C; Department of Cardiology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK., Scheinemann K; Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland; University of Basel, Basel, Switzerland; McMaster Children's Hospital and McMaster University, Hamilton, Canada., Schindera C; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Pediatric Hematology and Oncology, University Children's Hospital Basel, Basel, Switzerland., Tonorezos ES; National Cancer Institute, Office of Cancer Survivorship, USA., Wallace WH; Department of Paediatric Haematology and Oncology & University of Edinburgh, Royal Hospital for Sick Children, Edinburgh, UK., Constine LS; University of Rochester Medical Center, Rochester, USA., Skinner R; Great North Children's Hospital, and Newcastle University Centre for Cancer, Newcastle Upon Tyne, UK., Hudson MM; St. Jude Children's Research Hospital, Memphis, USA., Kremer LCM; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Levitt G; Department of Haematology/Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK., Mulrooney DA; St. Jude Children's Research Hospital, Memphis, USA. Electronic address: daniel.mulrooney@stjude.org.
Jazyk: angličtina
Zdroj: European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2021 Oct; Vol. 156, pp. 127-137. Date of Electronic Publication: 2021 Aug 24.
DOI: 10.1016/j.ejca.2021.06.021
Abstrakt: Background: Coronary artery disease (CAD) is a concerning late outcome for cancer survivors. However, uniform surveillance guidelines are lacking.
Aim: To harmonise international recommendations for CAD surveillance for survivors of childhood, adolescent and young adult (CAYA) cancers.
Methods: A systematic literature review was performed and evidence graded using the Grading of Recommendations, Assessment, Development and Evaluation criteria. Eligibility included English language studies, a minimum of 20 off-therapy cancer survivors assessed for CAD, and 75% diagnosed prior to age 35 years. All study designs were included, and a multidisciplinary guideline panel formulated and graded recommendations.
Results: 32 of 522 identified articles met eligibility criteria. The prevalence of CAD ranged from 0 to 72% and was significantly increased compared to control populations. The risk of CAD was increased among survivors who received radiotherapy exposing the heart, especially at doses ≥15 Gy (moderate-quality evidence). The guideline panel agreed that healthcare providers and CAYA cancer survivors treated with radiotherapy exposing the heart should be counselled about the increased risk for premature CAD. While the evidence is insufficient to support primary screening, monitoring and early management of modifiable cardiovascular risk factors are recommended. Initiation and frequency of surveillance should be based on the intensity of treatment exposures, family history, and presence of co-morbidities but at least by age 40 years and at a minimum of every 5 years. All were strong recommendations.
Conclusion: These systematically assessed and harmonised recommendations for CAD surveillance will inform care and guide research concerning this critical outcome for CAYA cancer survivors.
Competing Interests: Conflict of interest statement None declared.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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