CUKUROVA MEDICAL JOURNAL, cilt.44, sa.4, ss.1468-1472, 2019 (ESCI)
Current treatment of childhood cancers has developed as a risk-oriented approach considering clinical, biological, genetic factors and treatment response. Cardiac diseases are the most common cause of non-cancer death in long- term childhood cancer patients. Cardiomyopathy, congestive heart failure, pericardial effusion, constrictive pericarditis, coronary artery disease, myocardial infarction, and arrhythmias may develop with the toxic effects of chemotherapy and radiotherapy. Pulmonary complications such as radiation pneumonitis, pulmonary fibrosis and spontaneous pneumothorax, which are seen in previous years due to high dose radiotherapy are currently rarely seen. Long-term follow-up of patients who are treated with mediastinal radiotherapy and/or cardiotoxic agents, such as patients with Hodgkin lymphoma, is of vital importance. Left ventricular and heart valve functions should be monitored by echocardiography, QTc and rhythm abnormalities should be monitored by electrocardiography and other factors that may affect cardiovascular health and pulmonary function tests should be evaluated periodically. Computerized tomography angiography has a role of in the early identification of possible coronary abnormalities in Hodgkin lymphoma patients at risk for coronary artery disease due to the treatments they received, especially mediastinal radiotherapy.