Anthracycline-induced cardiotoxicity: risk assessment and management.

In the current issue of ONCOLOGY, Hershman and Shao provide a comprehensive review of anthracycline-induced cardiotoxicity (AIC). Risk factors for AIC include age (≤ 18 or ≥ 65 years) at time of treatment, increasing cumulative dose or dose intensity of anthracyclines, mediastinal radiation therapy (RT), and female gender.[1-4] The Surveillance, Epidemiology and End Results (SEER)-Medicare database showed that women 66 to 70 years of age who received nonanthracycline chemotherapy did not experience significant incremental cardiotoxicity compared to age-matched controls, but among the women who received anthracyclines, an excess rate of congestive heart failure (CHF) emerged.[5] For women 71 to 80 years of age, adjuvant chemotherapy type was not associated with CHF.