Cardio-toxicity in childhood cancer survivors “Cure is not enough”

According to the latest publication of data by the German Children’s cancer registry (DKKR), the 5-year survival rate for children aged under 15 years is estimated with 85%. Since 1980, 47,650 patients have been documented (1). Attention is drawn towards cardiac or cardiovascular sequelae in childhood cancer survivors. Accordingly, this topic was covered in adult cancer survivor studies leading to the ESC position paper on cardiac toxicity, quoted in the subtitle mentioned above (2). There are publications on chemotherapy-induced cardiotoxicity (mainly anthracycline-associated) and additional risk factors. Also radiation, chronic disease, combination of chemotherapies and the introduction of new drugs need to be considered (3). Furthermore, asymptomatic (subclinical) or symptomatic cardiac events have to be distinguished (4). Asymptomatic ventricular dysfunction has been reported to be as high as 57% (5,6). The appearance of cardiomyopathy is reported from 2.8% to 29%, mostly in accordance to-the dose of anthracyclines (7,8)