Nagykálnai Tamás, Nagy A Csaba, Landherr László
XV. kerületi Szakrendelő Onkológia Budapest.
Uzsoki utcai Kórház I. Belgyógyászat Budapest.
Orv Hetil. 2014 Jun 8;155(23):897-902. doi: 10.1556/OH.2014.29890.
Cardiac complications may present a particular problem following radiation treatment applied to the mediastinum and thoracic wall (and especially to the left breast). Exposure of the heart during radiotherapy increases the risk of ischemic heart disease occurring generally years after the treatment. The incidence of radiation cardiotoxicity depends on various factors related to oncological therapies and the patient (details of radiotherapy, age, gender, comorbidities, smoking habits, etc.). Until recently the majority of clinical studies reported increased cardiac morbidity in patients receiving radiation treatment of the chest wall and the breast. Due to modern methods, however, postoperative chest wall and left breast irradiation is much safer today than previously. In order to avoid cardiotoxicity, adherence to clinical practice guidelines for chemo- and targeted therapy of breast cancer, use of the most advanced irradiation procedures, regular monitoring of patients, and close cooperation between cardiologists and oncologists are all recommended.
在对纵隔和胸壁(尤其是左乳)进行放射治疗后,心脏并发症可能会成为一个特殊问题。放疗期间心脏暴露会增加治疗后数年发生缺血性心脏病的风险。放射性心脏毒性的发生率取决于与肿瘤治疗及患者相关的多种因素(放疗细节、年龄、性别、合并症、吸烟习惯等)。直到最近,大多数临床研究都报告称接受胸壁和乳房放射治疗的患者心脏发病率增加。然而,由于现代方法,如今术后胸壁和左乳照射比以前安全得多。为避免心脏毒性,建议遵循乳腺癌化疗和靶向治疗的临床实践指南,采用最先进的照射程序,定期监测患者,并让心脏病专家和肿瘤学家密切合作。