Paulides Marios, Wojnowski Leszek
Late Effects Surveillance System Studienleitung, Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Erlangen.
Med Klin (Munich). 2007 Jul 15;102(7):574-8. doi: 10.1007/s00063-007-1071-y.
Antineoplastic chemotherapy may induce acute or late side effects. Cytostatic-induced cardiomyopathy counts as one of the most dangerous side effects and has major implications for the use of anthracyclines. Since anthracyclines are widely employed and frequently indispensable cytostatics, it is important to elucidate the mechanisms and risk factors of the associated heart failure and develop preventive or interventional strategies.
Anthracycline-induced cardiomyopathy has been reported in up to 85% of treated patients. Known risk factors are younger age, advanced age, female gender, preexisting cardiac illness, cardiac irradiation, and other concomitant cardiotoxic medications. Proposed preventive strategies include the development of new anthracyclines, longer anthracycline infusion times, liposomal anthracycline formulations, the application of the iron chelator dexrazoxane, and identification of predisposing gene variants.
Most promising preventive strategies include longer infusion times, liposomal formulations, and the administration of the iron chelator dexrazoxane.
抗肿瘤化疗可能会引发急性或晚期副作用。细胞毒性药物诱发的心肌病是最危险的副作用之一，对蒽环类药物的使用有重大影响。由于蒽环类药物是广泛应用且常常不可或缺的细胞毒性药物，阐明相关心力衰竭的机制和危险因素并制定预防或干预策略很重要。
据报道，接受治疗的患者中高达85%出现蒽环类药物诱发的心肌病。已知的危险因素包括年龄较小、年龄较大、女性、原有心脏疾病、心脏放疗以及其他伴随的心脏毒性药物。提议的预防策略包括开发新的蒽环类药物、延长蒽环类药物输注时间、脂质体蒽环类药物制剂、应用铁螯合剂右丙亚胺以及识别易感基因变异。
最有前景的预防策略包括延长输注时间、脂质体制剂以及给予铁螯合剂右丙亚胺。
