Wu Vivian
University of Pennsylvania, Philadelphia, PA, USA
J Pediatr Oncol Nurs. 2015 May-Jun;32(3):178-84. doi: 10.1177/1043454214554008. Epub 2014 Nov 3.
Anthracyclines are a fundamental part of many childhood cancer therapy regimens; however, the discovery of anthracycline-induced cardiotoxicity has raised concern and led to dose limitation. The cardiotoxicity of anthracyclines has resulted in an increased demand for cardioprotectants. Dexrazoxane is the only cardioprotectant that has proven efficacy in reducing cardiotoxic effects when given prior to the administration of anthracyclines. Currently, it is still considered an "off-label" use due to a paucity of data in the literature on dexrazoxane administration in children. Nevertheless, through evaluation of the available data, dexrazoxane is observed to be safe, tolerable, and efficacious in mitigating the cardiotoxic effects of anthracycline in children, without jeopardizing its antineoplastic activity or increasing the risk of developing secondary malignant neoplasms.
蒽环类药物是许多儿童癌症治疗方案的基本组成部分;然而,蒽环类药物所致心脏毒性的发现引发了关注并导致剂量受限。蒽环类药物的心脏毒性使得对心脏保护剂的需求增加。右丙亚胺是唯一一种在蒽环类药物给药前使用时已被证明能有效减轻心脏毒性作用的心脏保护剂。目前,由于文献中关于儿童使用右丙亚胺的数据较少,它仍被视为“超说明书”用药。尽管如此,通过对现有数据的评估,观察到右丙亚胺在减轻儿童蒽环类药物心脏毒性作用方面是安全、可耐受且有效的,不会损害其抗肿瘤活性或增加发生继发性恶性肿瘤的风险。