Long-term chemotherapy-related cardiovascular morbidity

As a consequence of-the successful use of chemotherapy in the treatment of curable neoplasms such as germ cell tumours and malignant lymphomas, and th e increasing application of primary and adjuvant chemotherapy for various t umour types. the number of patients with a prolonged life expectancy after treatment is rising. Attention to long-term side-effects. including cardiov ascular toxicity, is therefore of growing importance. In this review we eva luate the literature on long-term cardiovascular toxicity related to chemot herapy in adult patients. Two categories of patient with favourable life ex pectancy have been reviewed, namely patients cured of metastatic disease by chemotherapy and patients treated with adjuvant chemotherapy. In the first , category. the literature on long-term cardiovascular morbidity in survivo rs of metastatic testicular cancer and lymphomas is discussed. while in the second category this is done for patients treated with adjuvant chemothera py for breast and colon cancer As well as the direct toxic effects of chemo therapy on the cardiovascular system. the indirect toxic effects such as ch emotherapy-related metabolic changes that may cause cardiovascular morbidit y are also discussed. (C) 2000 Harcourt Publishers Ltd.