ABSTRACT
University of Cincinnati College of Pharmacy, Cincinnati, Ohio, U.S.A.
INTRODUCTION
The treatment of malignant disease with antineoplastic agents has become more
widespread with the availability of additional active drugs and treatment regi-
mens. Adjuvant treatment programs attempting to eradicate microscopic disease
are now commonplace for breast, colorectal, lung, osteosarcoma, and testicular
tumors, and investigational in a number of other solid tumors. Neoadjuvant
chemotherapy regimens preceding definitive local treatment are now used in the
therapy of locally advanced breast cancer, osteosarcomas, head and neck tumors,
and, in some cases, non-small cell lung cancer. Patients with advanced testicular
tumors, small cell lung cancer, lymphomas, myeloma, and leukemias can
experience prolonged survival and, in some cases, are cured with chemotherapy
as the primary treatment. Many patients with metastatic and/or advanced disease
will receive successful palliative treatment with antineoplastics. The gains of
these treatment programs are not without risks of complications because of the
toxic nature of the agents used. Late abnormalities of left ventricular perfor-
mance have been reported in survivors of childhood cancers (1-6). Late car-
diotoxicity has been observed in bone marrow transplant patients who received
anthracyclines (7). Cardiac failure and dysrhythmias have occurred from 6 to
19 years after anthracycline therapy in some patients (8). Table 1 provides an
overview of the cardiotoxicity of various antineoplastic agents.
