Toxicité cardiaque des traitements du cancer chez l'enfant et l'adolescent

Childhood cancer is a success story of modern medicine in which effective treatments have been identified for a previously untreatable disease. The current 5-year survival rate reaches 80% and led us to focus on the long-term sequelae in this growing population of cancer survivors. Anthracyclines chemotherapy and mediastinal radiotherapy are both potentially cardiotoxic and contribute to a significant morbidity and mortality among cancer survivors. This review summarizes the physiopathology of cardiovascular diseases induced by cancer therapy, as well as their incidence and the risk factors associated with each specific therapy. We will expose in this review the most pertinent studies that have investigated the cardiac outcomes of adult surviving from childhood cancer. All demonstrated a substantial risk for late cardiac effects in this specific population. Cardiovascular monitoring, prevention tools and early detection strategies will also be developed. Early screening of cardiac dysfunction remaining the keystone of an improved long-term outcome for survivors of childhood cancer.