Risk Factors for Valvulopathy Among Childhood Cancer Survivors

Which treatments are associated with increased risk of symptomatic valvular heart disease (VHD) in long-term childhood cancer survivors?In this case-control study of 225 case patients and 442 controls, heart radiation therapy, high cumulative anthracycline doses, and exposure to platinum agents were associated with increased VHD risk. The heart radiation therapy dose response was exponential, and the risk increased with longer follow-up.The risk for VHD appears more strongly concentrated at high doses of heart radiation and anthracyclines, with exponential dose-response associations observed for both exposures.

Corresponding Author: Brice Fresneau, MD, PhD, Department of Children and Adolescents Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France (brice.fresneau@gustaveroussy.fr).

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