Valentová M, Mladosievicová B
Oddelenie klinickej patofyziológie Lekárskej fakulty UK Bratislava, Slovenská republika.
Vnitr Lek. 2010 Sep;56(9):915-9.
Increase of incidence and favorable prognosis of testicular cancer are accompanied by growing evidence of late complications following antineoplastic treatment, such as cardiovascular diseases, peripheral neuropathy, renal damage, hearing impairment, secondary malignancies, pulmonary toxicity, gonadal dysfunction and bone mineral density abnormalities. During the last years a sufficient evidence has been accumulated that there is a higher incidence of cardiovascular diseases, particularly in patients treated with high-dose cisplatin chemotherapy or mediastinal irradiation. Acute myocardial infarction and angina pectoris are the most common from cardiovascular complications. Several authors have reported high prevalence of hypertension, dyslipidemia, metabolic syndrome, endothelial dysfunction and also an excessive increase of body mass index among patients being treated successfully for testicular cancer. Pathogenesis of the cardiovascular toxicity remains still unclear. At present there are no clear and widely accepted recommendations on follow-up management including late complications of treatment for testicular cancer. Early identification of cardiovascular risk factors and their treatment may improve quality and expectancy of their life.
睾丸癌发病率的上升及良好预后伴随着抗肿瘤治疗后晚期并发症证据的不断增加,如心血管疾病、周围神经病变、肾损害、听力障碍、继发性恶性肿瘤、肺毒性、性腺功能障碍和骨矿物质密度异常。在过去几年中,已有充分证据表明心血管疾病的发病率较高,尤其是在接受高剂量顺铂化疗或纵隔放疗的患者中。急性心肌梗死和心绞痛是最常见的心血管并发症。几位作者报告称,在成功治疗睾丸癌的患者中,高血压、血脂异常、代谢综合征、内皮功能障碍的患病率较高,体重指数也过度增加。心血管毒性的发病机制仍不清楚。目前,对于包括睾丸癌治疗晚期并发症在内的随访管理,尚无明确且被广泛接受的建议。早期识别心血管危险因素并进行治疗可能会提高患者的生活质量和预期寿命。