The effect of anthracyclines on myocardial function in 50 long-term survivors of childhood cancer
Anthracyclines, which are effective in the treatment of childhood cancer, are known for their cardiotoxicity. In this study, with a mean follow-up of 116 months, the adverse effects of anthracyclines on conduction and myocardial function were evaluated by means of electrocardiography and echocardiography. ECG abnormalities, present in 2 patients, were nonspecific ST-segment and T-wave changes; cardiac function was normal. Echocardiographic abnormalities were present in 1 patient. He had a shortening fraction of less than 25% and presented in cardiac failure. Cardiotoxic effects of anthracyclines used in doses according to standard treatment protocols were minimal in this long-term follow-up study. Routine ECG and echocardiography in asymptomatic patients during long-term follow-up are not indicated when an anthracycline dose of less than 450 mg/m2 has been used and concomitant radiotherapy has not been administered.