PEDIATRICS Vol. 95 No. 5 May 1995, pp. 722-726
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pihkala, J.
Right arrow Articles by Saarinen, U. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pihkala, J.
Right arrow Articles by Saarinen, U. M.

Cardiopulmonary Evaluation of Exercise Tolerance After Chest Irradiation and Anticancer Chemotherapy in Children and Adolescents

Jaana Pihkala MD1, Juha-Matti Happonen MD1, Kari Virtanen MD2, Anssi Sovijärvi MD3, Martti A. Siimes MD1, Erkki Pesonen MD1, and Ulla M. Saarinen MD1

1 Children's Hospital, University of Helsinki, Helsinki, Finland
2 First Department of Medicine, University of Helsinki, Helsinki, Finland
3 Department of Pulmonary Medicine, University of Helsinki, Helsinki, Finland

Objective. The aim of the study was to evaluate the cardiopulmonary exercise tolerance in children and adolescents after chest irradiation and anticancer chemotherapy.

Methods. We studied 30 subjectively asymptomatic patients aged 8 to 25 years treated for pediatric malignancies with chest irradiation (XRT) ± chemotherapy. The median interval since XRT was 7 (range, 2 to 13) years. The median XRT dose for mediastinum and/or lungs was 2550 (range, 1000 to 5100) cGy. The median cumulative dose of anthracyclines was 250 (range, 0 to 480) mg/m2. Cardiac function and exercise tolerance were evaluated by electrocardiography, echocardiography, radionuclide cineangiography, and exercise test with gas exchange analysis.

Results. The patients differed from normal controls in systolic indices of myocardial function. In echocardiography, the left ventricular contractility was abnormal in 14/30 patients. In radionuclide cineangiography, the left ventricular ejection fraction was subnormal in 6/30 patients, and in 9/30 patients the rise in ejection fraction during exercise was inadequate (<5%). In exercise testing, the mean (±SD) maximum workload attained was 2.7 (±0.7) watts/kg, and the mean (±SD) maximum oxygen consumption was 35.4 (±9.7) mL/min/kg. Both variables were <80% of predicted values in 11 patients.

Conclusions. XRT and anticancer chemotherapy very often lead to late cardiopulmonary toxicity and impaired exercise tolerance. Although in most cases this toxicity seemed to be mild and subclinical, the long-term clinical sequels merit further evaluation.

Submitted on April 5, 1994
Accepted on August 12, 1994




This article has been cited by other articles:


Home page
 Journal of Pediatric Oncology NursingHome page
M. R. Keats, S. N. Culos-Reed, K. S. Courneya, and M. McBride
An Examination of Physical Activity Behaviors in a Sample of Adolescent Cancer Survivors
Journal of Pediatric Oncology Nursing, May 1, 2006; 23(3): 135 - 142.
[Abstract] [PDF]

Home page
 Arch. Dis. Child.Home page
E De Caro, F Fioredda, M G Calevo, A Smeraldi, M Saitta, G Hanau, M Faraci, F Grisolia, G Dini, G Pongiglione, et al.
Exercise capacity in apparently healthy survivors of cancer
Arch. Dis. Child., January 1, 2006; 91(1): 47 - 51.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
M. J. Adams, S. R. Lipsitz, S. D. Colan, N. J. Tarbell, S. T. Treves, L. Diller, N. Greenbaum, P. Mauch, and S. E. Lipshultz
Cardiovascular Status in Long-Term Survivors of Hodgkin's Disease Treated With Chest Radiotherapy
J. Clin. Oncol., August 1, 2004; 22(15): 3139 - 3148.
[Abstract] [Full Text] [PDF]

Home page
 J. Nutr.Home page
N. M. Aziz
Cancer Survivorship Research: Challenge and Opportunity
J. Nutr., November 1, 2002; 132(11): 3494S - 3503.
[Abstract] [Full Text] [PDF]