Westphal Julian G, Schulze P Christian
Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany.
J Thorac Dis. 2018 Dec;10(Suppl 35):S4391-S4399. doi: 10.21037/jtd.2018.12.53.
The therapeutic options for malignancies have been expanding over the past decades. Since the rise of targeted therapies, improved survival rates and decreased morbidity of cancer patients are evident but these refined protocols have steadily increased the number of patients at risk for long-term side-effects of anti-neoplastic treatments. The leading causes of death in cancer survivors are now defined by cardiovascular disease. Thus, there is a growing need for understanding how cancer related cardiovascular diseases such as cardiomyopathies or vasculopathies develop and how this can be prevented. Besides classical symptoms of heart failure with or without decompensation, an overwhelming majority of cancer patients develop fatigue and a significant reduction in exercise capacity when compared to their pre-cancer state. These effects seem to be independent from the specific chemotherapeutic substance included in the treatment regimen. Recent trials have suggested beneficial effects of exercise regiments in early and late phases of cancer treatment regimens and during rehabilitation. This review focuses on the currently available literature and evidence for the role of exercise training in preventing declining cardiac function or improving an already impaired function during or after chemotherapy, radiation or other cancer-specific therapies.
在过去几十年中，恶性肿瘤的治疗选择一直在不断扩展。自从靶向治疗兴起以来，癌症患者的生存率提高且发病率降低，这一点很明显，但这些完善的方案却稳步增加了面临抗肿瘤治疗长期副作用风险的患者数量。癌症幸存者的主要死因现在已由心血管疾病确定。因此，越来越需要了解诸如心肌病或血管病等与癌症相关的心血管疾病是如何发生的，以及如何预防。除了有或无失代偿的心力衰竭的经典症状外，与癌症前状态相比，绝大多数癌症患者会出现疲劳且运动能力显著下降。这些影响似乎与治疗方案中所包含的特定化疗药物无关。最近的试验表明，运动方案在癌症治疗方案的早期和晚期以及康复期间都有有益效果。本综述重点关注当前关于运动训练在预防化疗、放疗或其他癌症特异性治疗期间或之后心脏功能下降或改善已受损功能方面作用的现有文献和证据。
