Evidence map›Paper›PMID 41407887›Full record

SynthesisPediatric research2026

Cardiotoxicity in pediatric oncology: a systematic review and meta-analysis.

Nóra Beke, Xenia Jockers, Márk Hernádfői, Tamás Kói, Keve Lakatos, Andrea Párniczky, Péter Hegyi, Miklós Garami

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nóra BekeCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Xenia JockersCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Márk HernádfőiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Tamás KóiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Keve LakatosCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Andrea PárniczkyCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Péter HegyiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Miklós GaramiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary. garami.miklos@semmelweis.hu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnthracycline-induced cardiotoxicity is a major concern in childhood cancer survivors. Detecting subclinical cardiac dysfunction early is critical, but the accuracy of current diagnostic tools is uncertain.

methodsWe performed a systematic review and meta-analysis of studies evaluating the prognostic accuracy of echocardiography, serum biomarkers, microRNAs (miRNAs), and artificial intelligence (AI) models in predicting chemotherapy-induced cardiotoxicity in pediatric patients. Seventy-three studies were included in the qualitative synthesis, and ten in the meta-analysis. Quality was assessed using the QUAPAS tool (CRD42023485629).

resultsAI-based models showed the highest pooled predictive performance area under the curve (AUC)~0.80, despite significant heterogeneity (I² = 93%). Global longitudinal strain (GLS) had moderate accuracy (AUC~0.72). Cardiac biomarkers like troponin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) showed variable sensitivity and specificity, largely influenced by timing and thresholds. Preliminary evidence on miRNAs was promising but lacked standardization. Additional methods (e.g., cardiac MRI, cardiopulmonary exercise testing (CPET)) were excluded from meta-analysis due to methodological variability.

conclusionNo single modality reliably detects early cardiotoxicity. Promising tools like AI models and miRNAs need further validation. A multimodal diagnostic strategy combining imaging, biomarkers, and clinical data may be the most effective approach. Standardized definitions and protocols are urgently needed. IMPACT: Early detection of chemotherapy-induced cardiotoxicity in children remains unresolved. Multimodal assessment is most effective because no single test is sufficiently reliable. There are critical methodological gaps and heterogeneity that impede standardization in pediatric cardio-oncology. AI and microRNAs are promising but still unvalidated tools. The findings guide future clinical monitoring strategies and support standardized multimodal diagnostic algorithms.

Indexed as

AnthracyclinesAntineoplastic AgentsCardiotoxicityNeoplasmsArtificial IntelligenceBiomarkersChildEchocardiographyHeart DiseasesHumansMicroRNAsPediatricsAnthracyclinesAntineoplastic AgentsBiomarkersMicroRNAs

Identifiers

PMID41407887
PMCPMC13638469

What OpenQuestion holds

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Registered trials

None linked

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.