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儿童癌症治疗的心脏毒性:长期随访的最新情况及当前认知

Cardiotoxicity of childhood cancer treatment: update and current knowledge on long-term follow-up.

作者信息

de Ville de Goyet Maëlle, Moniotte Stéphane, Brichard Bénédicte

机构信息

Department of Paediatric Haematology and Oncology, Cliniques universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.

出版信息

Pediatr Hematol Oncol. 2012 Aug;29(5):395-414. doi: 10.3109/08880018.2012.694092. Epub 2012 Jun 25.

Abstract

Therapeutic advances in paediatric oncology allowed increasing numbers of children to survive until adulthood. However, chemotherapy and radiotherapy are potentially cardiotoxic and contribute to a significant morbidity and mortality, cardiovascular events remaining the leading cause of death among survivors. This review summarizes the physiopathology of treatment-related cardiovascular diseases, their incidence, and the risk factors associated with each specific therapy. Few studies have investigated the cardiac outcomes of adult surviving from childhood cancers but all demonstrated a substantial risk for late cardiac effects. Cardiovascular monitoring, prevention, and early detection of cardiac dysfunction are, therefore, the keystones of an improved long-term outcome.

摘要

儿科肿瘤学的治疗进展使越来越多的儿童存活至成年。然而,化疗和放疗具有潜在的心脏毒性,会导致显著的发病率和死亡率,心血管事件仍是幸存者的主要死因。本综述总结了治疗相关心血管疾病的病理生理学、发病率以及与每种特定疗法相关的危险因素。很少有研究调查儿童癌症成年幸存者的心脏结局,但所有研究都表明存在晚期心脏效应的重大风险。因此,心血管监测、预防和心脏功能障碍的早期检测是改善长期结局的关键。

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