Hameau René, Gabrielli Luigi, Garrido Marcelo, Guzmán Ana María, Retamal Ignacio, Vacarezza María José, Greig Douglas, Ocqueteau Mauricio, Sánchez César, Pizarro Marcela, Corvalán Alejandro, Lavandero Sergio, Castro Pablo F, Martínez Gonzalo
División de Enfermedad Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Departamento de Hematología y Oncología, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2018 Jan;146(1):68-77. doi: 10.4067/s0034-98872018000100068.
Recently, we have witnessed major improvements in cancer treatment. Early diagnosis and development of new therapies have reduced cancer-related mortality. However, these new therapies, along with greater patient survival, are associated with an increase in untoward effects, particularly in the cardiovascular system. Although cardiotoxicity induced by oncologic treatments affects predominantly the myocardium, it can also involve other structures of the cardiovascular system, becoming one of the main causes of morbidity and mortality in those who survive cancer. The main objective of cardio-oncology is to achieve the maximum benefits of oncologic treatments while minimizing their deleterious cardiovascular effects. It harbors the stratification of patients at risk of cardiotoxicity, the implementation of diagnostic tools (imaging techniques and biomarkers) for early diagnosis, preventive strategies and early treatment options for the complications. Herein, we discuss the basic knowledge for the implementation of cardio-oncology units and their role in the management of cancer patients, the diagnostic tools available to detect cardiotoxicity and the present therapeutic options.
最近，我们见证了癌症治疗取得的重大进展。早期诊断和新疗法的开发降低了癌症相关死亡率。然而，这些新疗法以及患者生存率的提高，伴随着不良反应的增加，尤其是在心血管系统方面。尽管肿瘤治疗引起的心脏毒性主要影响心肌，但它也可能累及心血管系统的其他结构，成为癌症幸存者发病和死亡的主要原因之一。心脏肿瘤学的主要目标是在将肿瘤治疗的有害心血管影响降至最低的同时，实现其最大益处。它包括对有心脏毒性风险的患者进行分层，实施用于早期诊断的诊断工具（成像技术和生物标志物）、预防策略以及针对并发症的早期治疗选择。在此，我们讨论建立心脏肿瘤学单元的基础知识及其在癌症患者管理中的作用、可用于检测心脏毒性的诊断工具以及当前的治疗选择。
