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<p>Due to multimodal treatment concepts and high standards of care, nearly 90% of children in Austria currently survive a&#xa0;malignant cancer. As a&#xa0;result, late effects, especially cardiovascular complications of the disease and treatment, are of increasing importance. Anthracyclines in particular, which are still being used in around 60% for pediatric chemotherapy and irradiation of areas close to the heart have a&#xa0;relevant long-term effect on the cardiovascular system. New treatment options, such as proteasome inhibitors, tyrosine kinase inhibitors, immune checkpoint inhibitors or blinatumomab also represent a&#xa0;relevant cardiovascular risk; however, the specific cardiotoxicity needs further investigation.</p><p>The delayed cardiac effects can be asymptomatic for a&#xa0;long time and may lead to manifest heart failure decades after the end of therapy. Early detection of myocardial dysfunction, which typically begins with diastolic functional impairment, is fundamental. Risk stratification based on the type and dose of cardiotoxic treatment received is useful for determining the frequency, extent and duration of cardiological aftercare.</p><p>For adults there are detailed guidelines on the cardio-oncological aftercare and on pharmacological treatment of chemotherapy-induced myocardial dysfunction, whereas for childhood tumors, which account for less than 1% of all tumors, there are so far no uniform recommendations.</p><p>This article summarizes the current state of knowledge regarding the acute and chronic cardiotoxicity of pediatric chemotherapy and irradiation and gives a&#xa0;recommendation for the cardiological aftercare for survivors of childhood and adolescent cancer in Austria.</p>

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Kardiologische Nachsorge von krebskranken Kindern und Jugendlichen in Österreich

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月11日

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  • Johannes Nairz,
  • Matthias Krainz,
  • Julia Feldscher,
  • Vanessa Vieth,
  • Andreas Hanslik,
  • Jutta Bergler-Klein,
  • Edit Bardi,
  • Doris Ehringer-Schetitska,
  • Christina Salvador,
  • Gabriele Kropshofer,
  • Michaela Höck,
  • Roman Crazzolara,
  • Miriam Michel

摘要

Due to multimodal treatment concepts and high standards of care, nearly 90% of children in Austria currently survive a malignant cancer. As a result, late effects, especially cardiovascular complications of the disease and treatment, are of increasing importance. Anthracyclines in particular, which are still being used in around 60% for pediatric chemotherapy and irradiation of areas close to the heart have a relevant long-term effect on the cardiovascular system. New treatment options, such as proteasome inhibitors, tyrosine kinase inhibitors, immune checkpoint inhibitors or blinatumomab also represent a relevant cardiovascular risk; however, the specific cardiotoxicity needs further investigation.

The delayed cardiac effects can be asymptomatic for a long time and may lead to manifest heart failure decades after the end of therapy. Early detection of myocardial dysfunction, which typically begins with diastolic functional impairment, is fundamental. Risk stratification based on the type and dose of cardiotoxic treatment received is useful for determining the frequency, extent and duration of cardiological aftercare.

For adults there are detailed guidelines on the cardio-oncological aftercare and on pharmacological treatment of chemotherapy-induced myocardial dysfunction, whereas for childhood tumors, which account for less than 1% of all tumors, there are so far no uniform recommendations.

This article summarizes the current state of knowledge regarding the acute and chronic cardiotoxicity of pediatric chemotherapy and irradiation and gives a recommendation for the cardiological aftercare for survivors of childhood and adolescent cancer in Austria.