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临床实践中的心血管肿瘤血液学。立场文件与建议。

Cardio-Onco-Hematology in Clinical Practice. Position Paper and Recommendations.

作者信息

López-Fernández Teresa, Martín García Ana, Santaballa Beltrán Ana, Montero Luis Ángel, García Sanz Ramón, Mazón Ramos Pilar, Velasco Del Castillo Sonia, López de Sá Areses Esteban, Barreiro-Pérez Manuel, Hinojar Baydes Rocío, Pérez de Isla Leopoldo, Valbuena López Silvia Cayetana, Dalmau González-Gallarza Regina, Calvo-Iglesias Francisco, González Ferrer Juan José, Castro Fernández Antonio, González-Caballero Eva, Mitroi Cristina, Arenas Meritxell, Virizuela Echaburu Juan Antonio, Marco Vera Pascual, Íñiguez Romo Andrés, Zamorano José Luis, Plana Gómez Juan Carlos, López Sendón Henchel José Luis

机构信息

Servicio de Cardiología, Hospital Universitario La Paz, Instituto de Investigación La Paz-IdiPAz, Madrid, Spain; Comisión de Trabajo Conjunta Sociedad Española de Cardiología-Sociedad Española de Oncología Médica-Sociedad Española de Oncología Radioterápica-Sociedad Española de Hematología, Spain.

Comisión de Trabajo Conjunta Sociedad Española de Cardiología-Sociedad Española de Oncología Médica-Sociedad Española de Oncología Radioterápica-Sociedad Española de Hematología, Spain; Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.

出版信息

Rev Esp Cardiol (Engl Ed). 2017 Jun;70(6):474-486. doi: 10.1016/j.rec.2016.12.041. Epub 2017 Mar 18.

Abstract

Improvements in early detection and treatment have markedly reduced cancer-related mortality. However survival not only depends on effectively cure cancer, but prevention, diagnosis and treatment of cancer-related complications is also needed. Cardiovascular toxicity is a widespread problem across many classes of therapeutic schemes, however scientific evidence in the management of cardiovascular complications of onco-hematological patients is scarce, as these patients have been systematically excluded from clinical trials and current recommendations are based on expert consensus. Multidisciplinary teams are mandatory to decrease morbidity and mortality from both cardiotoxicity and cancer itself. An excessive concern for the occurrence of cardiovascular toxicity, can avoid potentially curative therapies, while underestimating this risk, increases long-term mortality of cancer survivors. The objective of this consensus document, developed in collaboration of the Spanish Society of Cardiology, the Spanish Society of Medical Oncology, the Spanish Society of Radiation Oncology and the Spanish Society of Hematology, is to update the necessary concepts and expertise on cardio-onco-hematology that enable its application in daily clinical practice and to promote the development of local multidisciplinary teams, to improve the cardiovascular health of patients with cancer.

摘要

早期检测和治疗方面的改进显著降低了癌症相关死亡率。然而,生存不仅取决于有效治愈癌症,还需要预防、诊断和治疗癌症相关并发症。心血管毒性是许多治疗方案中普遍存在的问题,然而,关于肿瘤血液学患者心血管并发症管理的科学证据却很少,因为这些患者被系统性地排除在临床试验之外,目前的建议基于专家共识。多学科团队对于降低心脏毒性和癌症本身导致的发病率和死亡率至关重要。对心血管毒性发生的过度担忧可能会避免潜在的治愈性治疗,而低估这种风险则会增加癌症幸存者的长期死亡率。这份由西班牙心脏病学会、西班牙医学肿瘤学会、西班牙放射肿瘤学会和西班牙血液学会合作制定的共识文件的目的是更新心脏肿瘤血液学的必要概念和专业知识,使其能够应用于日常临床实践,并促进当地多学科团队的发展,以改善癌症患者的心血管健康。

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