Congestive heart failure after treatment for Wilms' tumor: a report from the National Wilms' Tumor Study group
| Autor: | Bin Nan, Pat A. Norkool, Janice R. Takashima, Daniel M. Green, G J D'Angio, Norman E. Breslow, Yevgeny A. Grigoriev |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Risk Cancer Research medicine.medical_specialty Heart disease medicine.medical_treatment Antineoplastic Agents Wilms Tumor Cohort Studies Actuarial Analysis Internal medicine medicine Humans Doxorubicin Risk factor Sex Distribution Child Heart Failure Chemotherapy Antibiotics Antineoplastic Dose-Response Relationship Drug Radiotherapy business.industry Infant Newborn Infant Wilms' tumor medicine.disease Combined Modality Therapy United States Surgery Logistic Models Oncology Heart failure Case-Control Studies Child Preschool Cardiology Female Complication business Kidney disease medicine.drug |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 19(7) |
| ISSN: | 0732-183X |
| Popis: | PURPOSE: We determined the frequency of and risk factors for congestive heart failure following treatment for Wilms’ tumor that included doxorubicin. PATIENTS AND METHODS: Flow sheets and medical records were reviewed to identify cases of congestive heart failure in a cohort of patients treated on National Wilms’ Tumor Studies (NWTS)-1, -2, -3, and -4. The frequency of congestive heart failure was estimated using the Kaplan-Meier method. A case-control study was conducted to determine the relationship among cumulative doxorubicin dose, site(s), total dose of abdominal and thoracic irradiation, sex, and the frequency of congestive heart failure. RESULTS: The cumulative frequency of congestive heart failure was 4.4% at 20 years after diagnosis among patients treated initially with doxorubicin and 17.4% at 20 years after diagnosis among those treated with doxorubicin for their first or subsequent relapse of Wilms’ tumor. The relative risk (RR) of congestive heart failure was increased in females (RR = 4.5; P = .004) and by cumulative doxorubicin dose (RR = 3.3/100 mg/m2; P < .001), lung irradiation (RR = 1.6/10 Gy; P = .037), and left abdominal irradiation (RR = 1.8/10 Gy; P = .013). CONCLUSION: We conclude that congestive heart failure is a risk of treatment with doxorubicin for Wilms’ tumor. Additional follow-up of those children treated on NWTS-4 will be necessary to determine if the decrease in dose to 150 mg/m2 significantly reduces this risk. |
| Databáze: | OpenAIRE |
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