Congestive heart failure after treatment for Wilms' tumor: A report from the National Wilms' Tumor Study Group

被引:216
作者
Green, DM
Grigoriev, YA
Nan, B
Takashima, JR
Norkool, PA
D'Angio, GJ
Breslow, NE
机构
[1] New York State Dept Hlth, Roswell Pk Canc Inst, Dept Pediat, Buffalo, NY 14263 USA
[2] SUNY Buffalo, Sch Med & Biomed Sci, Dept Pediat, Buffalo, NY 14260 USA
[3] Univ Washington, Dept Biostat, Seattle, WA 98195 USA
[4] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA
[5] Hosp Univ Penn, Dept Radiat Oncol, Philadelphia, PA 19104 USA
关键词
D O I
10.1200/JCO.2001.19.7.1926
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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/m(2); 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/m(2) significantly reduces this risk. <(c)> 2001 by American Society of Clinical Oncology.
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页码:1926 / 1934
页数:9
相关论文
共 52 条
[1]   HEPATIC IRRADIATION AND ADRIAMYCIN CARDIOTOXICITY [J].
BHANOT, P ;
CUSHING, B ;
PHILIPPART, A ;
DAS, L ;
FAROOKI, Z .
JOURNAL OF PEDIATRICS, 1979, 95 (04) :561-563
[2]   PILOT-STUDY OF CARDIAC-FUNCTION AFTER TREATMENT OF CHILDHOOD WILMS-TUMOR WITH DOXORUBICIN [J].
BLATT, J ;
DELAAT, C ;
FRICKER, FJ ;
JANOSKY, JE .
PEDIATRIC HEMATOLOGY AND ONCOLOGY, 1995, 12 (01) :61-66
[3]   NONPARAMETRIC-ESTIMATION OF RELATIVE MORTALITY FROM NESTED CASE-CONTROL STUDIES [J].
BORGAN, O ;
LANGHOLZ, B .
BIOMETRICS, 1993, 49 (02) :593-602
[4]   ETHNIC VARIATION IN THE INCIDENCE, DIAGNOSIS, PROGNOSIS, AND FOLLOW-UP OF CHILDREN WITH WILMS-TUMOR [J].
BRESLOW, N ;
OLSHAN, A ;
BECKWITH, JB ;
MOKSNESS, J ;
FEIGL, P ;
GREEN, D .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1994, 86 (01) :49-51
[5]  
BULOCK FA, 1995, BRIT HEART J, V73, P340
[6]   PERIOPERATIVE COMPLICATIONS IN PATIENTS WITH ANTHRACYCLINE CHEMOTHERAPEUTIC-AGENTS [J].
BURROWS, FA ;
HICKEY, PR .
CANADIAN ANAESTHETISTS SOCIETY JOURNAL, 1985, 32 (02) :149-157
[7]  
DANGIO GJ, 1976, CANCER-AM CANCER SOC, V38, P633, DOI 10.1002/1097-0142(197608)38:2<633::AID-CNCR2820380203>3.0.CO
[8]  
2-S
[9]  
DANGIO GJ, 1981, CANCER-AM CANCER SOC, V47, P2302, DOI 10.1002/1097-0142(19810501)47:9<2302::AID-CNCR2820470933>3.0.CO
[10]  
2-K