Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers

Publication Date: December 5, 2016
Last Updated: December 16, 2022

Risk

It is recommended that cancer patients who meet any of the following criteria should be considered at increased risk for developing cardiac dysfunction.

Treatment that includes any of the following:
  • High dose anthracycline (e.g. ≥250 mg/m2 doxorubicin, ≥600 mg/m2 epirubicin)
  • High dose (≥30 Gy) radiotherapy where the heart is in the treatment field
  • Lower dose anthracycline (e.g. <250 mg/m2 doxorubicin, <600 mg/m2 epirubicin) in combination with lower dose radiotherapy (<30 Gy) where the heart is in the treatment field
  • Treatment with lower dose anthracycline (e.g. <250 mg/m2 doxorubicin, <600 mg/m2 epirubicin) or trastuzumab alone, and presence of any of the following risk factors:
    • Multiple (≥2) cardiovascular risk factors, including: smoking, hypertension, diabetes, dyslipidemia, obesity during or after completion of therapy
    • Older (≥60 years) age at cancer treatment
    • Compromised cardiac function (e.g. borderline low LVEF [50–55%], history of myocardial infarction, ≥moderate valvular heart disease) at any time prior to or during treatment
  • Treatment with lower dose anthracycline (e.g. <250 mg/m2 doxorubicin, <600 mg/m2 epirubicin) followed by trastuzumab (sequential therapy)
( EB , H , H , M )
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Prevention

Prevention PRIOR TO Initiation of Therapy

Avoid or minimize the use of potentially cardiotoxic therapies if established alternatives exist that would not compromise cancer-specific outcomes. ( CB , H , B , )
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Overview

Title

Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers

Authoring Organization