Cardiovascular Late Effects Of Chemotherapy In Colorectal Cancer Patients

Background The acute cardiotoxicity of specific chemotherapeutic agents which are used in the treatment of colon cancer is well described. Although the survival prognosis for colorectal cancer patients has improved in recent years, cardiotoxic long-term effects after chemotherapy are largely unexplored. Objectives What are the most common cardiotoxic events following chemotherapy, how are these assessed in different study designs, and how long is the study period? Materials and methods A literature research on cardiovascular effects of chemotherapy in colorectal cancer patients was performed in two leading medical databases. Results The overall incidence of cardiovascular events in the 28 included studies is between 0.1% and 57.0%. The three most commonly reported cardiovascular symptoms are venous thromboembolism (10 studies; 0.1-35.6%), angina pectoris (6 studies; 0.8-8.5%) and heart failure (5 studies; 0.1-54.5%). More than half of the studies only reported events during chemotherapy (about 6 months). Of the studies with longer observation periods, over 60% focus on venous thromboembolism. Conclusion Venous thromboembolism needs special attention in patients with colorectal cancer, and patients as well as primary physicians need to be educated in early signs of cardiovascular symptoms and prevention measurements. Future studies should differentiate acute, early and late effects of cardiotoxicity and collect data on cardiovascular risk profiles. Study designs with longer observation periods and the linkage of cancer registry or health databases should be encouraged.