Prevention and Treatment of Cardiotoxicity in Cancer Patients
Impact on Ventricular Function and Clinical Management Strategies
DOI:
https://doi.org/10.56226/102Keywords:
Cardiotoxicity, Oncology, Ventricular function, Chemotherapy, RadiotherapyAbstract
Background: Cardiotoxicity is a significant complication in cancer patients resulting from treatments such as chemotherapy (CT) and radiotherapy (RT). This condition can lead to ventricular dysfunction and other cardiac complications, negatively impacting the quality of life and the effectiveness of cancer treatment.
Methods: This study reviews the literature on cardiotoxicity in cancer patients, focusing on prevention and treatment methods. Scientific articles, clinical guidelines and case studies were analyzed to identify effective clinical management strategies. The research included data on cardiac monitoring, use of cardioprotective medications and adjustments in cancer therapies.
Results: The analysis revealed that continuous monitoring of cardiac function is crucial for early detection of cardiotoxicity. Medications such as beta-blockers and ACE inhibitors are effective in protecting the heart. In addition, modifying chemotherapy doses and using more precise radiotherapy techniques can reduce the risk of cardiac damage. Multidisciplinary collaboration between oncologists and cardiologists is essential for effective management.
Conclusion: Prevention and treatment of cardiotoxicity in cancer patients are essential to improve clinical outcomes and quality of life. Strategies such as regular cardiac monitoring, use of cardioprotective agents and adaptation of oncological therapies are effective in mitigating adverse effects. Continuous research and innovation are vital for the development of new therapeutic approaches, ensuring safe and effective cancer treatment.
References
Ahmed, N., Brawley, V. S., Hegde, M., Robertson, C., Ghazi, A., Gerken, C., Liu, E., Dakhova, O., Ashoori, A., Corder, A., Gray, T., Wu, M. F., Liu, H., Hicks, J., Rainusso, N., Dotti, G., Mei, Z., Grilley, B., Gee, A., Rooney, C. M., … Gottschalk, S. (2015). Human Epidermal Growth Factor Receptor 2 (HER2) -Specific Chimeric Antigen Receptor-Modified T Cells for the Immunotherapy of HER2-Positive Sarcoma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 33(15), 1688–1696. https://doi.org/10.1200/JCO.2014.58.0225
Avila, M. S., Ayub-Ferreira, S. M., de Barros Wanderley, M. R., Jr, das Dores Cruz, F., Gonçalves Brandão, S. M., Rigaud, V. O. C., Higuchi-Dos-Santos, M. H., Hajjar, L. A., Kalil Filho, R., Hoff, P. M., Sahade, M., Ferrari, M. S. M., de Paula Costa, R. L., Mano, M. S., Bittencourt Viana Cruz, C. B., Abduch, M. C., Lofrano Alves, M. S., Guimaraes, G. V., Issa, V. S., Bittencourt, M. S., … Bocchi, E. A. (2018). Carvedilol for Prevention of Chemotherapy-Related Cardiotoxicity: The CECCY Trial. Journal of the American College of Cardiology, 71(20), 2281–2290. https://doi.org/10.1016/j.jacc.2018.02.049
Bhullar, K. S., Lagarón, N. O., McGowan, E. M., Parmar, I., Jha, A., Hubbard, B. P., & Rupasinghe, H. P. V. (2018). Kinase-targeted cancer therapies: progress, challenges and future directions. Molecular cancer, 17(1), 48. https://doi.org/10.1186/s12943-018-0804-2
Brown S. A. (2020). Preventive Cardio-Oncology: The Time Has Come. Frontiers in cardiovascular medicine, 6, 187. https://doi.org/10.3389/fcvm.2019.00187
Carneiro, GP, Nobre, M. do N., Costa, AN, Lemos, IC de M., Hamdan, SMM, & Neto, AJ de S. (2025). Cardiotoxicidade induzida por quimioterapia: uma revisão integrativa. Revista Brasileira de Revisão de Saúde , 8 (1), e78035. https://doi.org/10.34119/bjhrv8n1-531
da Silva Barreto, G., Brito do Nascimento, J., Cristina Santos de Almeida, K., Carlos Marcolino Neto, J., & Lucas Ferreira Luz da Silva, S. (2024). The CRISPR therapy: A revolutionary breakthrough in genetic medicine. International Healthcare Review (online). https://doi.org/10.56226/88
Dhesi, S., Chu, M. P., Blevins, G., Paterson, I., Larratt, L., Oudit, G. Y., & Kim, D. H. (2013). Cyclophosphamide-Induced Cardiomyopathy: A Case Report, Review, and Recommendations for Management. Journal of investigative medicine high impact case reports, 1(1), 2324709613480346. https://doi.org/10.1177/2324709613480346
Dobroski, A. U. B., Duarte, B. P. F., Tanganelli, C. B., Neto, E. M. O., Naddeo, M., Valdujo, N. S., Maluf, G., & Uyeda, M. (2025). Impact of Mutations in DNA Repair Genes in Lynch Syndrome: A Systematic Literature Review. International Healthcare Review (online). https://doi.org/10.56226/93
Escudier, M., Cautela, J., Malissen, N., Ancedy, Y., Orabona, M., Pinto, J., Monestier, S., Grob, J. J., Scemama, U., Jacquier, A., Lalevee, N., Barraud, J., Peyrol, M., Laine, M., Bonello, L., Paganelli, F., Cohen, A., Barlesi, F., Ederhy, S., & Thuny, F. (2017). Clinical Features, Management, and Outcomes of Immune Checkpoint Inhibitor-Related Cardiotoxicity. Circulation, 136(21), 2085–2087. https://doi.org/10.1161/CIRCULATIONAHA.117.030571
Farmakis, D., Parissis, J., & Filippatos, G. (2014). Insights into onco-cardiology: atrial fibrillation in cancer. Journal of the American College of Cardiology, 63(10), 945–953. https://doi.org/10.1016/j.jacc.2013.11.026
Giza, D. E., Lopez-Mattei, J., Vejpongsa, P., Munoz, E., Iliescu, G., Kitkungvan, D., Hassan, S. A., Kim, P., Ewer, M. S., & Iliescu, C. (2017). Stress-Induced Cardiomyopathy in Cancer Patients. The American journal of cardiology, 120(12), 2284–2288. https://doi.org/10.1016/j.amjcard.2017.09.009
Hajjar, L. A., Costa, I. B. S. da S. da ., Lopes, M. A. C. Q., Hoff, P. M. G., Diz, M. D. P. E., Fonseca, S. M. R., Bittar, C. S., Rehder, M. H. H. dos S., Rizk, S. I., Almeida, D. R., Fernandes, G. dos S., Beck-da-Silva, L., Campos, C. A. H. de M., Montera, M. W., Alves, S. M. M., Fukushima, J. T., Santos, M. V. C. dos ., Negrão, C. E., Silva, T. L. F. da ., … Kalil Filho, R.. (2020). Diretriz Brasileira de Cardio-oncologia – 2020. Arquivos Brasileiros De Cardiologia, 115(5), 1006–1043. https://doi.org/10.36660/abc.2020100
Herrmann J. (2020). Adverse cardiac effects of cancer therapies: cardiotoxicity and arrhythmia. Nature reviews. Cardiology, 17(8), 474–502. https://doi.org/10.1038/s41569-020-0348-1
Kawahara, L. T., Costa, I. B. S. da S., Barros, C. C. S., Almeida, G. C. de ., Bittar, C. S., Rizk, S. I., Testa, L., Moniz, C. M. V., Pereira, J., Oliveira, G. M. M. de ., Diz, M. D. P. E., Guimarães, P. O., Pinto, I. M., Kalil Filho, R., Hajjar, L. A., & Hoff, P. M.. (2020). Câncer e Doenças Cardiovasculares na Pandemia de COVID-19. Arquivos Brasileiros De Cardiologia, 115(3), 547–557. https://doi.org/10.36660/abc.20200405
Ma, W. W., Saif, M. W., El-Rayes, B. F., Fakih, M. G., Cartwright, T. H., Posey, J. A., King, T. R., von Borstel, R. W., & Bamat, M. K. (2017). Emergency use of uridine triacetate for the prevention and treatment of life-threatening 5-fluorouracil and capecitabine toxicity. Cancer, 123(2), 345–356. https://doi.org/10.1002/cncr.30321
Malik, S. B., Chen, N., Parker, R. A., 3rd, & Hsu, J. Y. (2017). Transthoracic Echocardiography: Pitfalls and Limitations as Delineated at Cardiac CT and MR Imaging. Radiographics : a review publication of the Radiological Society of North America, Inc, 37(2), 383–406. https://doi.org/10.1148/rg.2017160105
Marques da Silva, M., Matias Cunha, C., Aquino, C., Aquino, L., & Fernanda Pizo Ferreira, P. (2025). SBRT for Uncomplicated Bone Metastases in the Spine from Lung Cancer: A literature Review. International Healthcare Review (online). https://doi.org/10.56226/92
Mir, H., Alhussein, M., Alrashidi, S., Alzayer, H., Alshatti, A., Valettas, N., Mukherjee, S. D., Nair, V., & Leong, D. P. (2018). Cardiac Complications Associated With Checkpoint Inhibition: A Systematic Review of the Literature in an Important Emerging Area. The Canadian journal of cardiology, 34(8), 1059–1068. https://doi.org/10.1016/j.cjca.2018.03.012
Negishi, T., Thavendiranathan, P., Negishi, K., Marwick, T. H., & SUCCOUR investigators (2018). Rationale and Design of the Strain Surveillance of Chemotherapy for Improving Cardiovascular Outcomes: The SUCCOUR Trial. JACC. Cardiovascular imaging, 11(8), 1098–1105. https://doi.org/10.1016/j.jcmg.2018.03.019
Nishi, M., Wang, P. Y., & Hwang, P. M. (2021). Cardiotoxicity of Cancer Treatments: Focus on Anthracycline Cardiomyopathy. Arteriosclerosis, thrombosis, and vascular biology, 41(11), 2648–2660. https://doi.org/10.1161/ATVBAHA.121.316697
Nowsheen, S., Aziz, K., Park, J. Y., Lerman, A., Villarraga, H. R., Ruddy, K. J., & Herrmann, J. (2018). Trastuzumab in Female Breast Cancer Patients With Reduced Left Ventricular Ejection Fraction. Journal of the American Heart Association, 7(15), e008637. https://doi.org/10.1161/JAHA.118.008637
Plana, J. C., Galderisi, M., Barac, A., Ewer, M. S., Ky, B., Scherrer-Crosbie, M., Ganame, J., Sebag, I. A., Agler, D. A., Badano, L. P., Banchs, J., Cardinale, D., Carver, J., Cerqueira, M., DeCara, J. M., Edvardsen, T., Flamm, S. D., Force, T., Griffin, B. P., Jerusalem, G., … Lancellotti, P. (2014). Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 27(9), 911–939. https://doi.org/10.1016/j.echo.2014.07.012
Roboz, G. J., Ritchie, E. K., Carlin, R. F., Samuel, M., Gale, L., Provenzano-Gober, J. L., Curcio, T. J., Feldman, E. J., & Kligfield, P. D. (2014). Prevalence, management, and clinical consequences of QT interval prolongation during treatment with arsenic trioxide. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 32(33), 3723–3728. https://doi.org/10.1200/JCO.2013.51.2913
Russell, R. R., Alexander, J., Jain, D., Poornima, I. G., Srivastava, A. V., Storozynsky, E., & Schwartz, R. G. (2016). The role and clinical effectiveness of multimodality imaging in the management of cardiac complications of cancer and cancer therapy. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 23(4), 856–884. https://doi.org/10.1007/s12350-016-0538-8
Sara, J. D., Kaur, J., Khodadadi, R., Rehman, M., Lobo, R., Chakrabarti, S., Herrmann, J., Lerman, A., & Grothey, A. (2018). 5-fluorouracil and cardiotoxicity: a review. Therapeutic advances in medical oncology, 10, 1758835918780140. https://doi.org/10.1177/1758835918780140
Silva Ribeiro, L., & Cristina Uniat, K. (2025). On Public Health and New Prostate Cancer Screening Strategies: Comparison of Methods and Results for Prevention. International Healthcare Review (online). https://doi.org/10.56226/97
Tamargo, J., Caballero, R., & Delpón, E. (2015). Cancer chemotherapy and cardiac arrhythmias: a review. Drug safety, 38(2), 129–152. https://doi.org/10.1007/s40264-014-0258-4
Song, C., & Xie, H. (2023). On Disparities in Breast Cancer Screening: An Analysis of Behavioral Risk Factor Surveillance Survey Data related to Racial/ Ethnic characteristics. International Healthcare Review (online). https://doi.org/10.56226/53
Timóteo, A. T., Papoila, A. L., Lopes, J. P., Oliveira, J. A., Ferreira, M. L., & Cruz Ferreira, R. (2013). Is it possible to simplify risk stratification scores for patients with ST-segment elevation myocardial infarction undergoing primary angioplasty?. Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official
journal of the Portuguese Society of Cardiology, 32(12), 967–973. https://doi.org/10.1016/j.repc.2013.06.006
Uyeda, M. (2022). On a Global Agenda for Oncology Research: From Biomarker studies to post-genomic technologies. International Healthcare Review (online), 1(1). https://doi.org/10.56226/ihr.v1i1.9
Vaghela, M. (2024). Diet effect on Cardiac Vascular Diseases: A qualitative study on the effects of diet modification in the United Kingdom. International Healthcare Review (online). https://doi.org/10.56226/61
Watanabe, H., Ichihara, E., Kano, H., Ninomiya, K., Tanimoto, M., & Kiura, K. (2017). Congestive Heart Failure During Osimertinib Treatment for Epidermal Growth Factor Receptor (EGFR)-mutant Non-small Cell Lung Cancer (NSCLC). Internal medicine (Tokyo, Japan), 56(16), 2195–2197. https://doi.org/10.2169/internalmedicine.8344-16
Zamorano, J. L., Lancellotti, P., Rodriguez Muñoz, D., Aboyans, V., Asteggiano, R., Galderisi, M., Habib, G., Lenihan, D. J., Lip, G. Y. H., Lyon, A. R., Lopez Fernandez, T., Mohty, D., Piepoli, M. F., Tamargo, J., Torbicki, A., Suter, T. M., & ESC Scientific Document Group (2016). 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). European heart journal, 37(36), 2768–2801. https://doi.org/10.1093/eurheartj/ehw211
Zhao, D., Chen, J., Liu, X., Long, X., Cao, L., & Wang, J. (2018). Atrial fibrillation following treatment with paclitaxel: A case report. Biomedical reports, 9(6), 540–544. https://doi.org/10.3892/br.2018.1158
Zei, P. C., & Soltys, S. (2017). Ablative Radiotherapy as a Noninvasive Alternative to Catheter Ablation for Cardiac Arrhythmias. Current cardiology reports, 19(9), 79. https://doi.org/10.1007/s11886-017-0886-2
Zijiu, C., Li, W., & Qin, J. (2025). Philosophical Reflections on Chinese Naturopathy against Malignant Tumours. International Healthcare Review (online). https://doi.org/10.56226/99
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