Cardiac dysfunction in medulloblastoma survivors treated with photon irradiation.

ECHO surveillance cardiac toxicity echocardiogram pediatric brain tumor

Journal

Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528

Informations de publication

Date de publication:
Aug 2022
Historique:
entrez: 21 7 2022
pubmed: 22 7 2022
medline: 22 7 2022
Statut: epublish

Résumé

Medulloblastoma is an aggressive central nervous system (CNS) tumor that occurs mostly in the pediatric population. Treatment often includes a combination of surgical resection, craniospinal irradiation (CSI), and chemotherapy. Children who receive standard photon CSI are at risk for cardiac toxicities including coronary artery disease, left ventricular scarring and dysfunction, valvular damage, and atherosclerosis. Current survivorship guidelines recommend routine echocardiogram (ECHO) surveillance. In this multi-institutional study, we describe markers of cardiac dysfunction in medulloblastoma survivors. A retrospective chart review of medulloblastoma patients who had photon beam CSI was followed by ECHO between 1980 and 2010 at Lurie Children's Hospital and Dana-Farber/Boston Children's Hospital. During the 30-year study period, 168 medulloblastoma patient records were identified. Included in this study were the 75 patients who received CSI or spinal radiation and ECHO follow-up. The mean age at CSI was 8.6 years (range, 2.9-20), and the mean number of years between radiation therapy (RT) completion and first ECHO was 7.4 (range, 2-16). Mean ejection fraction (EF) was 60.0% and shortening fraction (SF) was 33.8%. Five patients (7%) had abnormal ECHO results: three with EF <50% and two with SF <28%. The majority of medulloblastoma patients who received CSI have relatively normal ECHOs post-treatment; however, 7% of patients had abnormal ECHOs. The implication of our study for medulloblastoma survivors is that further investigations are needed in this population with a more systematic, longitudinal assessment to determine predictors and screenings.

Sections du résumé

Background UNASSIGNED
Medulloblastoma is an aggressive central nervous system (CNS) tumor that occurs mostly in the pediatric population. Treatment often includes a combination of surgical resection, craniospinal irradiation (CSI), and chemotherapy. Children who receive standard photon CSI are at risk for cardiac toxicities including coronary artery disease, left ventricular scarring and dysfunction, valvular damage, and atherosclerosis. Current survivorship guidelines recommend routine echocardiogram (ECHO) surveillance. In this multi-institutional study, we describe markers of cardiac dysfunction in medulloblastoma survivors.
Methods UNASSIGNED
A retrospective chart review of medulloblastoma patients who had photon beam CSI was followed by ECHO between 1980 and 2010 at Lurie Children's Hospital and Dana-Farber/Boston Children's Hospital.
Results UNASSIGNED
During the 30-year study period, 168 medulloblastoma patient records were identified. Included in this study were the 75 patients who received CSI or spinal radiation and ECHO follow-up. The mean age at CSI was 8.6 years (range, 2.9-20), and the mean number of years between radiation therapy (RT) completion and first ECHO was 7.4 (range, 2-16). Mean ejection fraction (EF) was 60.0% and shortening fraction (SF) was 33.8%. Five patients (7%) had abnormal ECHO results: three with EF <50% and two with SF <28%.
Conclusion UNASSIGNED
The majority of medulloblastoma patients who received CSI have relatively normal ECHOs post-treatment; however, 7% of patients had abnormal ECHOs. The implication of our study for medulloblastoma survivors is that further investigations are needed in this population with a more systematic, longitudinal assessment to determine predictors and screenings.

Identifiants

pubmed: 35859541
doi: 10.1093/nop/npac030
pii: npac030
pmc: PMC9290868
doi:

Types de publication

Journal Article

Langues

eng

Pagination

338-343

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Auteurs

Chantel Cacciotti (C)

Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.

Christine Chordas (C)

Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.

Katie Valentino (K)

Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA.

Rudy Allen (R)

Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA.

Alicia Lenzen (A)

Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA.

Karen Burns (K)

Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.

Rajaram Nagarajan (R)

Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.

Peter Manley (P)

Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.

Natasha Pillay-Smiley (N)

Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA.

Classifications MeSH