Chemotherapy – Induced Cardiotoxicity.

ABSTRACT

Use of chemotherapeutic agents in cancer patients have resulted in marked improvement in survival rates, chemoinduced cardiotoxicity is a well-known side effect of such several cytotoxic drugs, especially of the anthracyclines causing long term morbidity among cancer survivors. Formation of free radicals leading to oxidative stress leading to apoptosis of cardiac cells or immunologic reactions seems to be the mechanism of anthracycline induced cardiotoxicity. The risk for cardiotoxicity depends upon cumulative dose, rate of drug administration, gender, age, pre-existing heart disease, hypertention and mediastinal radiation. Serial cardiac imaging studies remain as routine monitoring methods to assess left ventricular systolic function and cardiotoxicity. Cardiac biomarker like Troponin I may be a sensitive and specific marker for predicting the development and severity of ventricular dysfunction. Limitation of the cumulative dose, addition of the antioxidant and iron chelatordexrazoxane to anthracycline therapy have shown to be effective in lowering the incidence of anthracycline induced cardiotoxicity. This review-article is highlighting the paramount importance for awareness of risk factors among practitioners, timely communication and collaboration between oncologists and cardiologists within a multidisciplinary team for prevention, early detection and treatment of such cardiotoxicity.