ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2019
Therapy-Related Cardiac Risk in Childhood Cancer Survivors: An Analysis of the Childhood Cancer Survivor Study.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
89 citing papers in PubMed, 1 synthesis or guideline pooled it, 144 citations in OpenAlex.
- Prevalence and management of hypertension in childhood, adolescent, and young adult cancer survivors: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Pooled it
- Late Cardiac Toxic Effects Associated With Treatment Protocols for Hodgkin Lymphoma in Children.JAMA network open · 2024Trial
- Estimation of Detailed Cardiac Doses for Pediatric Radiation Therapy Patients in National Wilms Tumor Study.International journal of radiation oncology, biology, physics · 2026Article
- Childhood cancer and future cardiometabolic health.npj metabolic health and disease · 2026Review
- The Relationship Between Physical Activity and Left Ventricular Remodeling in Childhood Cancer Survivors Treated With Anthracyclines: A Cross-Sectional Study.Pediatric blood & cancer · 2026Observational
- Late cardiac effects of anthracycline-based therapy in childhood cancer survivors: a CMR study of cardiac strain and function.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Longitudinal Assessment of Cardiac Function After Craniospinal Irradiation in Pediatric Central Nervous System Tumor Survivors.JACC. Advances · 2026Article
- Heart Disease in Survivors of Childhood Cancer: Data From the German Childhood Cancer Registry and Statutory Health Insurance Carriers (the VersKiK Study).Deutsches Arzteblatt international · 2026Observational
- Heart transplantation in pediatric oncology patients.JHLT open · 2026Article
- Successful allogeneic stem cell transplant in a patient with a left ventricular assist device: a novel case report.Annals of hematology · 2026Article
- Cardiac radiosensitivity in the era of thoracic chemoradiotherapy and immunotherapy: a scoping review.The Lancet. Oncology · 2026Article
- Subsequent Primary Neoplasms and Mortality Among Survivors of Childhood Cancer in Alberta, Canada.Cancers · 2026Article
- Individualized Dose-volume Reconstruction Workflow for the Normal Tissues of Pediatric Patients Treated with Passive Scattering Proton Therapy.Radiation research · 2026Article
- Evaluating the safety and cardiac impact of resistance training in anthracycline-treated patients: a systematic review.Cardio-oncology (London, England) · 2026Review
- Risk factors for cardiac dysfunction caused by anthracycline drugs in the treatment of lymphoma and the early monitoring value of three-dimensional echocardiography.American journal of cancer research · 2026Article
- Risk Factors for Valvulopathy Among Childhood Cancer Survivors.JAMA oncology · 2025Article
- Risk of Heart Failure Hospitalization in Patients Treated With Osimertinib: A Population-Based Retrospective Cohort Study.JACC. CardioOncology · 2025Article
- Radiation-Induced Cardiac Remodeling: Mechanisms and Therapeutic Approaches.Cardiovascular toxicology · 2025Review
- Unraveling the genetic blueprint of doxorubicin-induced cardiotoxicity through systems genetics approaches.Cardio-oncology (London, England) · 2025Article
- Improving cancer patients' prognosis by incorporating mindfulness intervention into the treatment strategy.World journal of psychiatry · 2025Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
Abstract
purposeThe impacts of radiotherapy dose and exposed cardiac volume, select chemotherapeutic agents, and age at exposure on risk for late-onset cardiac disease in survivors of childhood cancer remain unresolved. PATIENTS AND
methodsWe determined the rates of severe to fatal cardiac disease in 24,214 5-year survivors in the Childhood Cancer Survivor Study diagnosed between 1970 and 1999 at a median age of 7.0 years (range, 0 to 20.9 years), with a median attained age of 27.5 years (range, 5.6 to 58.9 years). Using piecewise exponential models, we evaluated the association between cardiac disease rates and demographic and treatment characteristics.
resultsThe cumulative incidence of cardiac disease 30 years from diagnosis was 4.8% (95% CI, 4.3 to 5.2). Low to moderate radiotherapy doses (5.0 to 19.9 Gy) to large cardiac volumes (≥ 50% of heart) were associated with an increased rate of cardiac disease (relative rate, 1.6; 95% CI, 1.1 to 2.3) compared with survivors without cardiac radiotherapy exposure. Similarly, high doses (≥ 20 Gy) to small cardiac volumes (0.1% to 29.9%) were associated with an elevated rate (relative rate, 2.4; 95% CI, 1.4 to 4.2). A dose-response relationship was observed between anthracycline chemotherapy and heart failure with younger children (age ≤ 13 years) at the greatest risk for heart failure after comparable dosing.
conclusionThese observations support advances in radiation field design and delivery technology to reduce cardiac dose/volume and should guide future treatment protocols. They also inform clinical practice guidelines for post-therapy surveillance and risk-reducing strategies.
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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.