Claire Berger1,2,3,4, Léonie Casagranda1,2,3,4, Vincent Pichot4, Béatrice Trombert-Paviot2,3,4, Cécile Faure-Conter5, Claire Freycon6, Florentina Isfan7, Isabelle Guichard8, Isabelle Durieu9, Arnauld Garcin4,10, Fréderic Roche4, Hugues Patural4,11. 1. 1 Department of Pediatric Hematology and Oncology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France. 2. 2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, Saint-Etienne, France. 3. 3 Department of Public Health and Medical Informatics, University of Saint-Etienne, Saint-Etienne, France. 4. 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France. 5. 5 Institute of Pediatric Hematology and Oncology, Lyon, France. 6. 6 Department of Pediatric Hematology and Oncology Unit, University Hospital of Grenoble, Grenoble, France. 7. 7 Department of Pediatric Hematology and Oncology Unit, University Hospital Estaing Clermont-Ferrand, Clermont-Ferrand, France. 8. 8 Department of Internal Medicine Unit, University Hospital, Saint-Etienne, France. 9. 9 Department of Internal Medicine and Vascular Pathology Unit, University Hospital of Lyon Sud, Pierre-Bénite, France. 10. 10 Department of Research and University Hospital, Saint-Etienne Cedex, France. 11. 11 Department of Pediatrics, University Hospital, Saint-Etienne Cedex, France.
Abstract
PURPOSE: Survival rate of childhood cancers is now reaching 80% overall. However, early or late complications related to surgery, chemotherapy, and radiotherapy remain at a high rate and greatly increase the risk of late mortality. The objective of this study is to assess the autonomic nervous system (ANS) activity, measured through heart rate variability indices in childhood cancer survivors compared with healthy controls. METHODS: This prospective study included 51 long-term childhood cancer survivors diagnosed before 15 years of age between 1987 and 1992 and controlled for age and sex with healthy volunteers. RESULTS: We observed a significant increase in spontaneous heart rate (beats per minute) (67 ± 10 vs. 60 ± 10, p = 0.001), and all the studied parameters showed a significantly altered ANS activity in cases compared with healthy controls. In both groups, the main cofactors of dysautonomia (tobacco, drugs, cannabis, estro-progestative pills, alcohol, limited physical activity) were analyzed without any significant difference. The effect of cancer treatments received was not analyzed due to the small number of participants. CONCLUSION: The results showed a significant ANS dysfunction in childhood cancer survivors compared with healthy controls and suggested the value of autonomic screening to underscore and possibly quantify the effect of the cancer treatments in a larger cohort. This evaluation could lead to the recommendation to increase physical activity, the most efficient way known to improve ANS activity, as already shown in other pathologies (breast cancer).
PURPOSE: Survival rate of childhood cancers is now reaching 80% overall. However, early or late complications related to surgery, chemotherapy, and radiotherapy remain at a high rate and greatly increase the risk of late mortality. The objective of this study is to assess the autonomic nervous system (ANS) activity, measured through heart rate variability indices in childhood cancer survivors compared with healthy controls. METHODS: This prospective study included 51 long-term childhood cancer survivors diagnosed before 15 years of age between 1987 and 1992 and controlled for age and sex with healthy volunteers. RESULTS: We observed a significant increase in spontaneous heart rate (beats per minute) (67 ± 10 vs. 60 ± 10, p = 0.001), and all the studied parameters showed a significantly altered ANS activity in cases compared with healthy controls. In both groups, the main cofactors of dysautonomia (tobacco, drugs, cannabis, estro-progestative pills, alcohol, limited physical activity) were analyzed without any significant difference. The effect of cancer treatments received was not analyzed due to the small number of participants. CONCLUSION: The results showed a significant ANS dysfunction in childhood cancer survivors compared with healthy controls and suggested the value of autonomic screening to underscore and possibly quantify the effect of the cancer treatments in a larger cohort. This evaluation could lead to the recommendation to increase physical activity, the most efficient way known to improve ANS activity, as already shown in other pathologies (breast cancer).
Entities:
Keywords:
autonomic nervous system; childhood cancer survivors; dysautonomia; long-term follow-up