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Clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review

Clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review
Clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review
This review systematically assessed the evidence on the clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer. We searched eight electronic databases, including Medline and the Cochrane Library, from inception to January 2006 for systematic reviews and randomised controlled trials that reported death, heart failure, arrhythmias or measures of cardiac performance associated with cardioprotective technologies compared with standard treatment in children treated for cancer with anthracyclines. Economic evaluations were also sought. Inclusion criteria, data extraction and quality assessment were undertaken by standard methodology. Four randomised controlled trials met the inclusion criteria of the review; each had methodological limitations. No economic evaluations were identified. Studies were combined through narrative synthesis. One trial found that continuous infusion of doxorubicin did not offer any cardioprotection over rapid infusion. One suggested that continuous infusion of daunorubicin provoked less cardiotoxicity than rapid infusion. One concluded that dexrazoxane reduces cardiac injury during doxorubicin therapy and one reported a protective effect of coenzyme Q(10) on cardiac function during anthracycline therapy. The evidence on the effectiveness of cardioprotective technologies in children is limited in quality and quantity thus making conclusions difficult. This is surprising given the importance of anthracycline use in children with cancer. Further long-term research, which includes relevant outcome measures, is needed to determine whether technologies influence the development of cardiac damage without limiting the antitumour efficacy of anthracyclines.
cardioprotection, anthracyclines, children, systematic review
0007-0920
226-230
Bryant, J.
508f497c-8b5a-468f-a37d-be9c26e4e49d
Picot, J.
324d6f20-a105-49fd-9fb0-88791be84ada
Baxter, L.
eeafbfe7-ae7e-421f-a6b6-c6d9df80b6ef
Levitt, G.
e368043e-6492-4b02-9359-e00ec5f0eae8
Sullivan, I.
5ced8efe-2404-4970-93a2-359268870aed
Clegg, A.
838091f5-39df-4dbe-a369-675b26f2301b
Bryant, J.
508f497c-8b5a-468f-a37d-be9c26e4e49d
Picot, J.
324d6f20-a105-49fd-9fb0-88791be84ada
Baxter, L.
eeafbfe7-ae7e-421f-a6b6-c6d9df80b6ef
Levitt, G.
e368043e-6492-4b02-9359-e00ec5f0eae8
Sullivan, I.
5ced8efe-2404-4970-93a2-359268870aed
Clegg, A.
838091f5-39df-4dbe-a369-675b26f2301b

Bryant, J., Picot, J., Baxter, L., Levitt, G., Sullivan, I. and Clegg, A. (2007) Clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review. British Journal of Cancer, 96 (2), 226-230. (doi:10.1038/sj.bjc.6603562). (PMID:14984495)

Record type: Article

Abstract

This review systematically assessed the evidence on the clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer. We searched eight electronic databases, including Medline and the Cochrane Library, from inception to January 2006 for systematic reviews and randomised controlled trials that reported death, heart failure, arrhythmias or measures of cardiac performance associated with cardioprotective technologies compared with standard treatment in children treated for cancer with anthracyclines. Economic evaluations were also sought. Inclusion criteria, data extraction and quality assessment were undertaken by standard methodology. Four randomised controlled trials met the inclusion criteria of the review; each had methodological limitations. No economic evaluations were identified. Studies were combined through narrative synthesis. One trial found that continuous infusion of doxorubicin did not offer any cardioprotection over rapid infusion. One suggested that continuous infusion of daunorubicin provoked less cardiotoxicity than rapid infusion. One concluded that dexrazoxane reduces cardiac injury during doxorubicin therapy and one reported a protective effect of coenzyme Q(10) on cardiac function during anthracycline therapy. The evidence on the effectiveness of cardioprotective technologies in children is limited in quality and quantity thus making conclusions difficult. This is surprising given the importance of anthracycline use in children with cancer. Further long-term research, which includes relevant outcome measures, is needed to determine whether technologies influence the development of cardiac damage without limiting the antitumour efficacy of anthracyclines.

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More information

Published date: 23 January 2007
Keywords: cardioprotection, anthracyclines, children, systematic review
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 345697
URI: http://eprints.soton.ac.uk/id/eprint/345697
ISSN: 0007-0920
PURE UUID: f6fc8843-7e14-43fb-95e3-48aefc807771
ORCID for J. Picot: ORCID iD orcid.org/0000-0001-5987-996X

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Date deposited: 29 Nov 2012 15:48
Last modified: 17 Dec 2019 01:48

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Contributors

Author: J. Bryant
Author: J. Picot ORCID iD
Author: L. Baxter
Author: G. Levitt
Author: I. Sullivan
Author: A. Clegg

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