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Subclinical late cardiac toxicity in childhood cancer survivors
Impact on self-reported health
Article first published online: 29 FEB 2008
Copyright © 2008 American Cancer Society
Volume 112, Issue 8, pages 1835–1844, 15 April 2008
How to Cite
Cox, C. L., Rai, S. N., Rosenthal, D., Phipps, S. and Hudson, M. M. (2008), Subclinical late cardiac toxicity in childhood cancer survivors. Cancer, 112: 1835–1844. doi: 10.1002/cncr.23378
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- Issue published online: 4 APR 2008
- Article first published online: 29 FEB 2008
- Manuscript Accepted: 29 AUG 2007
- Manuscript Revised: 16 JUL 2007
- Manuscript Received: 4 APR 2007
- National Institutes of Health. Grant Number: CA 21765
- American Lebanese Syrian Associated Charities
- childhood cancer;
- late effects;
- cardiac toxicity;
- perceived health
The authors analyzed how self-reported health and self-reported modified New York Heart Association (NYHA) cardiac function scores were related to cardiac systolic function, cardiac risk factors, and cancer treatment history in childhood cancer survivors who reported no symptoms of cardiac disease.
Long-term survivors of pediatric cancer who were treated between 1971 and 1995 (current ages, 16–39.7 years) underwent noninvasive clinical and laboratory cardiac risk evaluation and responded to selected subscales of the Medical Outcomes Study 36-item Short Form Health Survey. Results were compared with survivor history of anthracycline therapy alone or with radiotherapy (n = 127 patients; mean, 10 years after diagnosis) versus no anthracycline therapy (n = 32 patients; mean, 11 years after diagnosis).
Sex, current age, highest school grade completed, race, age at diagnosis, diagnostic group, years off therapy, fractional shortening (FS), heart rate, and smoking status were found to be independently predictive of self-reported health. Interaction between female sex and higher low-density lipoprotein values and between diagnosis and abnormal FS variably predicted low reported vitality and low reported modified New York Heart Association (NYHA) scores. Echocardiographic findings, cardiac risk factors, and treatment history explained 13% to 28% of the variance in perceived health and self-reported modified NYHA scores.
Systolic function and cardiac risk factors were linked to lower self-reported health and NYHA scores even in the absence of clinically evident cardiotoxicity. Cancer 2008. ©2008 American Cancer Society.