Cardiotoxicity After Childhood Cancer Treatment

Childhood cancer survival rates have drastically improved over the past few decades. Unfortunately this population experiences a significantly increased risk of excess morbidity and early mortality, of which cardiotoxicity is among the leading causes. Cardiotoxicity may present acutely during treatment or decades after completion of therapy and includes disease states such as congestive heart failure, hypertension, and early cardiac death. A multitude of both therapy-related and non-modifiable risk factors contribute to the development of cardiotoxicity. Treatments with anthracyclines, radiation, and targeted therapies such as VEGF inhibitors put patients at particularly increased risk. Screening for and identifying survivors at risk of cardiotoxicity is extremely important. Utilizing preventive measures such as the cardioprotective medication dexrazoxane with anthracyclines and reducing radiation exposure when feasible can avoid cardiotoxicity among patients; however, no specific therapies for treatment have been standardized for those who do develop adverse cardiac effects. Fortunately the number of childhood cancer survivors will continue to grow. It is therefore essential that research in the prevention of and treatment for cardiotoxicity continues and is at the forefront of discovery.