Cardiac
Monitoring
Screening is recommended for several decades after completion of therapy. There appears to be no point at which screening is no longer necessary.
The importance of monitoring is undisputed, but how often different investigations should be performed is the subject of much debate.
Below are the current CSG guidelines: These guidelines were developed as a collaborative effort of the Nursing Discipline and the Late Effects Committee and are maintained and updated by the Children’s Oncology Group’s Long-Term Follow-Up Guidelines Core Committee and its associated Task Forces.
This table is copied from their website and is a suggested schedule for echocardiogram or MUGA scan:
| Age at the time of treatment | Chest RT | Total Anthracycline dose | Recommended frequency of Echo or MUGA |
|---|---|---|---|
| Less than 1 year old | Yes | Any | Every year |
| No | Less 200 mg/m2 | Every 2 years | |
| No | Over 200 mg/m2 | Every year | |
| 1 to 4 years old | Yes | Any | Every year |
| No | Less 100 mg/m2 | Every 5 years | |
| No | Over 100 mg/m2 Less 300 mg/m2 |
Every 2 years | |
| No | Over 300 mg/m2 | Every year | |
| Over or equal to 5 years old | Yes | Less 300 mg/m2 | Every 2 years |
| Yes | Over 300 mg/m2 | Every year | |
| No | Less 200 mg/m2 | Every 5 years | |
| No | Over 200 mg/m2 Less 300 mg/m2 |
Every 2 years | |
| No | Over 300 mg/m2 | Every year |
They suggest that survivors who have received RT to 40 Gy or more to the heart or 30 Gy plus anthracycline therapy should be evaluated by a cardiologist for a stress test 5 to 10 years after their therapy was given.
They also suggest that it would be reasonable to check for lipidemia in cancer survivors every 2 years.
Please follow this link to view the original document:
Keeping your heart healthy after treatment for childhood cancer
