A child treated for cancer may be at risk for heart failure. Chow et al developed several models for predicting this risk. The authors are from multiple institutions in Europe and North America.
Patient selection: cancer therapy as child through 40 years of age
Outcome: heart failure by age 40 yeras
Parameters:
(1) gender
(2) age at cancer diagnosis
(3) anthracycline dose
(4) chest or heart radiotherapy in Gy
Parameter
Finding
Points
gender
male
0
female
1
age at cancer diagnosis
< 5 years of age
2
5 to 14 years of age
1
>= 15 years of age
0
anthracycline dose
none
0
1 to 100 mg per square meter
2
100 to 249 mg per square meter
3
>= 250 mg per square meter
4
chest or heart radiotherapy
< 5 Gy
0
5.0 to 14.9 Gy
1
15 to 34.9 Gy
3
>= 35 Gy
4
where:
• The radiation doses were given as whole numbers.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
• The higher the score the greater the risk of heart failure.
Score
Risk
0 to 2
low
3 to 5
moderate
6 to 8
high
9 to 11
very high
Performance:
• The area under the ROC cure is 0.77.
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