Heart Failure Clinical Trial
To provide a comprehensive analysis of risk factors for the development of clinical cardiotoxicities in over 6,000 children with cancer who had been treated on standardized protocols involving the use of anthracyclines alone or in combination with other potentially cardiotoxic therapies or with no use of anthracycline therapy.
DESIGN NARRATIVE:
The data were analyzed to estimate the incidence of clinical cardiotoxicity as measured by
sudden death, congestive heart failure, or discontinuation of therapy based on cardiac
function. Evaluation of patient characteristics (age, anemia) and treatment factors such as
drug, dose level, dosing schedule, exposure to irradiation and/or cyclophosphamide
identified groups at particularly high risk for development of clinical cardiotoxicity and
provided estimates of this risk for future treatment planning. Such estimates of high risk
groups should make possible future trials to test the feasibility of using cardioprotectors
or alternate dosing schedules to prevent cardiotoxicity. The incidence of clinical
cardiotoxicity was calculated using Kaplan- Meier estimates as a function of total
cumulative anthracycline dose and also as a function of the time since the end of treatment
stratified by dose levels. The estimates were stratified by exposure to cyclophosphamide and
radiation therapy. Multivariate methods were used to evaluate the prognostic significance of
selected patient characteristics and treatment parameters and to provide estimates of the
relative risk of each variable. The method of recursive partitioning was used to identify
subpopulations at elevated risk for clinical cardiotoxicity. The data and analytic
techniques were accessible through SAS data sets and procedures available to the study at
the Pediatric Oncology Group (POG) Statistical Office.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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