The association between retinoblastoma and cardiovascular disease in post-chemotherapy patients: A systematic review and meta analysis approach

Abstract

Background: Retinoblastoma (RB) is the most common primary intraocular malignancy in children. Advances in chemotherapy have significantly improved survival rates, but concerns about long-term cardiovascular complications persist. Anthracycline-based chemotherapy, particularly doxorubicin, has been implicated in increasing the risk of cardiovascular diseases (CVD) among survivors. Objective: This study aims to analyze the association between RB and cardiovascular diseases in patients post-chemotherapy, highlighting the long-term effects of treatment. Methods: A systematic review of recent studies (2015-2024) was conducted to assess cardiovascular outcomes in RB survivor’s post-chemotherapy. Data were collected from PubMed, Scopus, and Web of Science. The inclusion criteria encompassed studies evaluating CVD risk factors such as cardiomyopathy, hypertension, and atherosclerosis. Results: Analysis of 20 studies demonstrated a significant increase in CVD risk among RB survivors. The incidence of chemotherapy-induced cardiomyopathy was reported in 22-35% of patients. Elevated levels of inflammatory markers (CRP, IL-6) and endothelial dysfunction were observed in long-term survivors. Early cardiovascular screening and lifestyle modifications played a crucial role in reducing morbidity. Conclusion: Survivors of RB treated with chemotherapy are at an increased risk of developing cardiovascular diseases. Long-term surveillance and tailored interventions are necessary to mitigate these risks.