Berg Tove, Böhmer Jens, Nwaru Bright, Karason Kristjan, Jarfelt Marianne
Department of Pediatric Medicine, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Pediatrics, Frankfurt Hoechst Clinic, Frankfurt am Main, Germany.
Acta Oncol. 2025 Jul 23;64:917-926. doi: 10.2340/1651-226X.2025.43654.
Heart failure is a well-recognised and serious non-malignant late complication among childhood cancer survivors. The primary aim of conducting this systematic review was to identify, critically appraise and synthesise population-based studies reporting on the incidence and/or prevalence of heart failure in 5-year survivors of childhood cancer (age < 18 years).
We conducted this systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) in April 2021 (registration number: CRD42021247622) and published in June 2022. We searched databases Medline, Embase, Scopus, CINAHL, CAB International, AMED, Global Health, Psycinfo, Web of science and Google Scholar from their inception date until March 14, 2023. Screening, data extraction and quality assessment were conducted independently by two reviewers. The Effective Public Healthcare Practice Project tool was used for quality assessment.
Following a comprehensive review of the 3,883 records, only four were found to be eligible for inclusion. The overall quality of the studies was evaluated as strong in two studies and moderate in the remaining two studies. A subsequent meta-analysis of three comparable studies yielded a cumulative incidence of 0.99% (95% confidence interval [CI] 0.57-1.42) over an extended period of 5.0-72.5 years (I-squared = 94.4%, p < 0.001).
Existing population-based studies reporting on heart failure in 5-year childhood cancer survivors are few and heterogeneous. Future population-based studies comparing heart failure incidence in childhood cancer survivors with the general population would be of significant value.
心力衰竭是儿童癌症幸存者中一种公认的严重非恶性晚期并发症。开展这项系统评价的主要目的是识别、严格评估和综合基于人群的研究，这些研究报告了儿童癌症（年龄<18岁）5年幸存者中心力衰竭的发病率和/或患病率。
我们按照PRISMA（系统评价和Meta分析的首选报告项目）指南进行了这项系统评价。该方案于2021年4月在国际系统评价前瞻性注册库（PROSPERO）注册（注册号：CRD42021247622），并于2022年6月发表。我们检索了Medline、Embase、Scopus、CINAHL、CAB International、AMED、Global Health、Psycinfo、Web of science和Google Scholar数据库，检索时间从各数据库创建之日至2023年3月14日。由两名评审员独立进行筛选、数据提取和质量评估。使用有效公共医疗实践项目工具进行质量评估。
在对3883条记录进行全面审查后，仅发现4条符合纳入标准。两项研究的整体质量评估为强，其余两项研究为中等。随后对三项可比研究进行的Meta分析得出，在5.0至72.5年的较长时间内，累积发病率为0.99%（95%置信区间[CI]0.57 - 1.42）（I² = 94.4%，p < 0.001）。
现有的基于人群的关于儿童癌症5年幸存者心力衰竭的研究较少且具有异质性。未来基于人群的比较儿童癌症幸存者与普通人群心力衰竭发病率的研究将具有重要价值。
