Dong Jerry, Chen Hong
Cardiovascular Biology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States.
Case Western Reserve University, Cleveland, OH, United States.
Front Cardiovasc Med. 2018 Feb 7;5:9. doi: 10.3389/fcvm.2018.00009. eCollection 2018.
As cancer therapeutics continues to improve and progress, the adverse side effects associated with anticancer treatments have also attracted more attention and have become extensively explored. Consequently, the importance of posttreatment follow-ups is becoming increasingly relevant to the discussion. Contemporary treatment methods, such as tyrosine kinase inhibitors, anthracycline chemotherapy, and immunotherapy regimens are effective in treating different modalities of cancers; however, these reagents act through interference with DNA replication or prevent DNA repair, causing endothelial dysfunction, generating reactive oxygen species, or eliciting non-specific immune responses. Therefore, cardiotoxic effects, such as hypertension, heart failure, and left ventricular dysfunction, arise posttreatment. Rising awareness of cardiovascular complications has led to meticulous attention for the evolution of treatment strategies and carefully monitoring between enhanced treatment effectiveness and minimization of adverse toxicity to the cardiovasculature, in which psychological assessments, early detection methods such as biomarkers, magnetic resonance imaging, and various drugs to reverse the damage from cardiotoxic events are more prevalent and their emphasis has increased tremendously. Fully understanding the mechanisms by which the risk factors action for various patients undergoing cancer treatment is also becoming more prevalent in preventing cardiotoxicity down the line.
随着癌症治疗方法不断改进和进步，与抗癌治疗相关的不良副作用也引起了更多关注，并得到了广泛研究。因此，治疗后随访的重要性在相关讨论中变得越来越重要。当代治疗方法，如酪氨酸激酶抑制剂、蒽环类化疗和免疫治疗方案，在治疗不同类型的癌症方面是有效的；然而，这些药物通过干扰DNA复制或阻止DNA修复起作用，导致内皮功能障碍、产生活性氧或引发非特异性免疫反应。因此，治疗后会出现心脏毒性作用，如高血压、心力衰竭和左心室功能障碍。对心血管并发症认识的提高，使得人们对治疗策略的演变给予了细致关注，并在提高治疗效果与将对心血管系统的不良毒性降至最低之间进行仔细监测，其中心理评估、生物标志物等早期检测方法、磁共振成像以及各种用于逆转心脏毒性事件损伤的药物更为普遍，且其重要性也大幅提高。充分了解各种接受癌症治疗的患者的危险因素作用机制，在预防未来的心脏毒性方面也变得越来越普遍。
