Harake Danielle, Franco Vivian I, Henkel Jacqueline M, Miller Tracie L, Lipshultz Steven E
Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
Future Cardiol. 2012 Jul;8(4):647-70. doi: 10.2217/fca.12.44.
Advances in cancer treatment have greatly improved survival rates of children with cancer. However, these same chemotherapeutic or radiologic treatments may result in long-term health consequences. Anthracyclines, chemotherapeutic drugs commonly used to treat children with cancer, are known to be cardiotoxic, but the mechanism by which they induce cardiac damage is still not fully understood. A higher cumulative anthracycline dose and a younger age of diagnosis are only a few of the many risk factors that identify the children at increased risk of developing cardiotoxicity. While cardiotoxicity can develop at anytime, starting from treatment initiation and well into adulthood, identifying the best cardioprotective measures to minimize the long-term damage caused by anthracyclines in children is imperative. Dexrazoxane is the only known agent to date, that is associated with less cardiac dysfunction, without reducing the oncologic efficacy of the anthracycline doxorubicin in children. Given the serious long-term health consequences of cancer treatments on survivors of childhood cancers, it is essential to investigate new approaches to improving the safety of cancer treatments.
癌症治疗的进展极大地提高了患癌儿童的存活率。然而，这些相同的化疗或放疗可能会导致长期健康问题。蒽环类药物是常用于治疗患癌儿童的化疗药物，已知具有心脏毒性，但其导致心脏损伤的机制仍未完全明确。累积蒽环类药物剂量较高以及诊断时年龄较小只是众多表明儿童发生心脏毒性风险增加的危险因素中的一部分。虽然心脏毒性可在任何时候发生，从治疗开始直至成年期，但确定最佳的心脏保护措施以尽量减少蒽环类药物对儿童造成的长期损害至关重要。右丙亚胺是迄今为止唯一已知的与较少心脏功能障碍相关的药物，且不会降低蒽环类药物阿霉素对儿童的肿瘤疗效。鉴于癌症治疗对儿童癌症幸存者造成的严重长期健康后果，研究提高癌症治疗安全性的新方法至关重要。
