Ruggiero A, Ridola V, Puma N, Molinari F, Coccia P, De Rosa G, Riccardi R
Division of Paediatric Oncology, Catholic University of Rome, Rome, Italy.
Pediatr Hematol Oncol. 2008 Jun;25(4):261-81. doi: 10.1080/08880010802016649.
Over the last 40 years, a significant advance has been made in the treatment of childhood and adult cancers. However, the increase of the survival rate points out medium- and long-term adverse effects that constitute a serious limitation for the quality of life in adults survived from a childhood cancer. Cardiovascular disease is an important cause of morbidity and mortality in adults treated with chemo- and radiotherapy for childhood cancers. Although some antitumor treatments are potentially cardiotoxic, anthracycline therapy and radiotherapy are mostly responsible for long-term cardiac damage. Anthracycline toxicity is generally limited to the myocardium, while radiation can cause injury to all components of the heart. The purpose of this review is to discuss the mechanisms of action of anthracyclines, their cardiotoxicity, the feasibility of screening, and the prevention of cardiac damage after treatment in childhood.
在过去40年里，儿童和成人癌症的治疗取得了重大进展。然而，生存率的提高也凸显了中长期的不良反应，这对成年期存活的儿童癌症幸存者的生活质量构成了严重限制。心血管疾病是接受化疗和放疗的儿童癌症成年患者发病和死亡的重要原因。虽然一些抗肿瘤治疗可能具有心脏毒性，但蒽环类药物治疗和放疗是导致长期心脏损伤的主要原因。蒽环类药物的毒性通常局限于心肌，而放疗会对心脏的所有组成部分造成损伤。本综述的目的是探讨蒽环类药物的作用机制、心脏毒性、筛查的可行性以及儿童期治疗后心脏损伤的预防。
