Congestive Heart Failure After Treatment for Wilms' Tumor: A report from the National Wilms' Tumor Study Group

Daniel M. Green, Yevgeny A. Grigoriev, Bin Nan, Janice R. Takashima, Pat A. Norkool, Guilio J. D'Angio, and Norman E. Breslow
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001

Share article


Reviewers: Li Liu, MD
Source: Journal of Clinical Oncology, Vol 19, Issue 7 (April), 2001: 1926-1934

Introduction

The prognosis for children with Wilms' tumor has improved dramatically during the past three decades. The purpose of this study was to examine the frequency of and risk factors for congestive heart failure (CHF) in patients whose treatment included doxorubicin on the National Wilms' Tumor Studies (NWTS) -1, -2, -3, and -4, and to evaluate other possible risk factors for the occurrence of CHF. CHF was considered to have occurred if the patient required treatment with digoxin and diuretics.

Method

The NWTS were multi-institutional randomized trials for different treatment regimens for patients who were younger than 16 years of age at diagnosis with Wilms' tumor. Flow sheets and medical records were reviewed to identify cases of CHF in this cohort of patients. A case-control study was conducted to determine the relationship among cumulative doxorubicin dose, site(s) and total dose of abdominal and thoracic irradiation, gender, and frequency of CHF.

Results and Discussion

The researchers identified CHF as a significant morbidity in children treated with doxorubicin and thoracic or left abdominal irradiation for Wilms' tumor. Female patients were at greater risk for CHF than male patients, and former patients should be told of their risk for developing cardiac disease. These patients should be monitored closely by a cardiologist prior to the initiation of a vigorous program of physical activity or getting pregnant.


News
Folic Acid Enrichment May Reduce Specific Pediatric Cancers

May 22, 2012 - Following mandatory folic acid fortification of enriched grain products in the United States in 1996 to 1998, there has been a decrease in the incidence of some childhood cancers, including Wilms tumor and primitive neuroectodermal tumors, according to a study published online May 21 in Pediatrics.


Frequently Asked Questions

National Cancer Institute

Conferences

I Wish You Knew

How cancer patients have changed my life

View More



Blogs and Web Chats

OncoLink Blogs give our readers a chance to react to and comment on key cancer news topics and provides a forum for OncoLink Experts and readers to share opinions and learn from each other.




OncoLink OncoPilot

Facing a new cancer diagnosis or changing the course of your current treatment? Let our cancer nurses help you through!

Learn More