Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
Cardiac monitoring in adolescent and young adult cancer patients treated with anthracyclines: a longitudinal descriptive study.
СтатьяНазвание и аннотация: Перевод в очереди
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Gao Jingwei, Fukasawa Toshiki, Yamada Shuhei, Takeuchi Masato, Yamaguchi Fumitaka, Fan Di, Kawakami Koji
Аннотация
PURPOSE: We quantified the real-world prevalence of echocardiographic monitoring and identified factors associated with baseline echocardiography among adolescent and young adult (AYA; 15-39 years) cancer patients treated with anthracyclines in Japan.
METHODS: We performed a descriptive study using a Japanese health insurance claims database in patients initiating anthracycline chemotherapy between April 2012 and July 2020. We calculated the proportion undergoing echocardiography within 180 days before therapy (baseline); before the second, fourth, and sixth cycles; at any time during therapy; and within 1 year after completion. Risk ratios for receipt of baseline echocardiography by patient and institutional characteristics were estimated using univariable modified Poisson regression.
RESULTS: Among 1459 AYA patients (mean age, 31.7 years; 65.1% female), 60.4% underwent baseline echocardiography. Utilization declined to 8.2%, 11.4%, and 20.9% before the second, fourth, and sixth cycles, respectively; was 13.7% at any time during therapy; and 41.0% within 1-year post-therapy. Baseline echocardiography was more common for age 15-19 and 20-29 years (vs. ≥ 30-39 years) and males; lymphoma, leukemia, bone sarcoma, and pre-existing heart failure; and chemotherapy at a designated cancer hospital. Likelihood was lower for breast cancer; clinic (vs. university hospital); and epirubicin, idarubicin, or pirarubicin (vs. doxorubicin).
CONCLUSION: Echocardiographic monitoring before, during, and after anthracycline therapy in Japanese AYA patients is suboptimal, with marked disparities by age, sex, cancer type, anthracycline agent, and treatment setting. Targeted quality-improvement initiatives and harmonized risk-stratified monitoring pathways are needed to prevent unrecognized anthracycline-related cardiomyopathy in this vulnerable population.
METHODS: We performed a descriptive study using a Japanese health insurance claims database in patients initiating anthracycline chemotherapy between April 2012 and July 2020. We calculated the proportion undergoing echocardiography within 180 days before therapy (baseline); before the second, fourth, and sixth cycles; at any time during therapy; and within 1 year after completion. Risk ratios for receipt of baseline echocardiography by patient and institutional characteristics were estimated using univariable modified Poisson regression.
RESULTS: Among 1459 AYA patients (mean age, 31.7 years; 65.1% female), 60.4% underwent baseline echocardiography. Utilization declined to 8.2%, 11.4%, and 20.9% before the second, fourth, and sixth cycles, respectively; was 13.7% at any time during therapy; and 41.0% within 1-year post-therapy. Baseline echocardiography was more common for age 15-19 and 20-29 years (vs. ≥ 30-39 years) and males; lymphoma, leukemia, bone sarcoma, and pre-existing heart failure; and chemotherapy at a designated cancer hospital. Likelihood was lower for breast cancer; clinic (vs. university hospital); and epirubicin, idarubicin, or pirarubicin (vs. doxorubicin).
CONCLUSION: Echocardiographic monitoring before, during, and after anthracycline therapy in Japanese AYA patients is suboptimal, with marked disparities by age, sex, cancer type, anthracycline agent, and treatment setting. Targeted quality-improvement initiatives and harmonized risk-stratified monitoring pathways are needed to prevent unrecognized anthracycline-related cardiomyopathy in this vulnerable population.