SynthesisJournal of pediatric hematology/oncology2018
Dexrazoxane Significantly Reduces Anthracycline-induced Cardiotoxicity in Pediatric Solid Tumor Patients: A Systematic Review.
Synthesis in Journal of pediatric hematology/oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Preventive use of beta-blockers for anthracycline-induced cardiotoxicity: A network meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Cardiotoxicity, survival, and dexrazoxane use in patients with soft tissue sarcoma: a Danish population‑based cohort study.Acta oncologica (Stockholm, Sweden) · 2026Article
- Cardiovascular Care in Pediatric Cancer Survivors: Updates on Risk, Prevention, and Therapies.Current treatment options in oncology · 2025Review
- Topobexin targets the Topoisomerase II ATPase domain for beta isoform-selective inhibition and anthracycline cardioprotection.Nature communications · 2025Article
- Review
- Cardio-Oncology's Modern Approaches to Prevent Doxorubicin-Induced Cardiotoxicity: A Systematic Review.Cureus · 2024Review
- Prevention of Anthracyclines and HER2 Inhibitor-Induced Cardiotoxicity: A Systematic Review and Meta-Analysis.Cancers · 2024Review
- Cardiovascular Toxicity of Antineoplastic Treatments in Hematological Diseases: Focus on Molecular Mechanisms to Improve Therapeutic Management.Journal of clinical medicine · 2024Review
- Cardiotoxicity of Anticancer Drugs: Molecular Mechanisms, Clinical Management and Innovative Treatment.Drug design, development and therapy · 2024Review
- Cardio-oncology for Pediatric and Adolescent/Young Adult Patients.Current treatment options in oncology · 2023Review
- Doxorubicin Dose Deintensification in Pediatric Osteosarcoma, Is Less Better?South Asian journal of cancer · 2023Article
- Correlating decline in left ventricular ejection fraction and longitudinal strain in pediatric cancer patients.The international journal of cardiovascular imaging · 2023Article
- Cardiac events among patients with sarcoma treated with doxorubicin by method of infusion: A real-world database study.Cancer reports (Hoboken, N.J.) · 2023Article
- Clinical characterization and natural history of chemotherapy-induced dilated cardiomyopathy.ESC heart failure · 2022Article
- Delphi Panel Consensus Recommendations for Screening and Managing Childhood Cancer Survivors at Risk for Cardiomyopathy.JACC. CardioOncology · 2022Article
- Cardioprotective effects of sodium thiosulfate against doxorubicin-induced cardiotoxicity in male rats.BMC pharmacology & toxicology · 2022Article
- Sex-Specific Cardiovascular Risks of Cancer and Its Therapies.Circulation research · 2022Review
- Pediatric Cardio-Oncology Medicine: A New Approach in Cardiovascular Care.Children (Basel, Switzerland) · 2021Review
- Review
- Mechanisms and Insights for the Development of Heart Failure Associated with Cancer Therapy.Children (Basel, Switzerland) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
Cardiotoxicity is a dose-limiting and potentially lethal complication of anthracycline administration. Previous studies failed to determine definitive toxic doses or cardioprotective factors. Current dosing strategies may utilize unnecessarily high anthracycline doses, such that survival benefit may not outweigh increased toxicity rates. A systematic review of randomized controlled trials and prospective/retrospective studies investigating anthracycline treatment in pediatric solid tumors was performed from PubMed/MEDLINE and Cochrane databases. Generalized linear models mapping survival, cardiotoxicity, and cardiotoxicity-free survival adjusted for male-to-female ratio, follow-up time, and concomitant chemotherapeutic drugs or cardioprotective agents (dexrazoxane) were generated using R. Survival rose linearly with increasing cumulative anthracycline dose whereas cardiotoxicity demonstrated exponential increases both without (dose, >200 mg/m) and with (dose, >400 mg/m) dexrazoxane. Maximum cardiotoxicity-free survival was 268.2 mg/m without and 431.8 mg/m with dexrazoxane. Despite increasing cardiotoxicity-free dose by >150 mg/m, dexrazoxane minimally improved projected survival (71.9% vs. 75.4%). Cardiotoxicity increased linearly as a function of follow-up time with rates doubling from 5 to 20 years, without evidence of plateau. On the basis of our model, current dosing regimens-doxorubicin doses >375 mg/m without dexrazoxane-overvalue increased anthracycline administration and may contribute to devastating cardiotoxicity. The linear increase of cardiotoxicity without evidence of plateau confirms the necessity for lifelong cardiac monitoring.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.