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巴西心血管肿瘤学:圣保罗州立癌症研究所的 10 年经验。

Brazilian cardio-oncology: the 10-year experience of the Instituto do Cancer do Estado de Sao Paulo.

机构信息

Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo avenue, 251, São Paulo, 01246-000, Brazil.

Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

BMC Cardiovasc Disord. 2020 Apr 28;20(1):206. doi: 10.1186/s12872-020-01471-8.

Abstract

BACKGROUND

In recent years, the field of cardio-oncology has grown worldwide, bringing benefits to cancer patients in terms of survival and quality of life. This study reports the experience of a pioneer cardio-oncology programme at University Cancer Hospital in Brazil over a period of 10 years, describing the clinical profile of patients and the clinical outcomes.

METHODS

A retrospective study was conducted on a cohort of patients treated at the cardio-oncology programme from April 2009 to February 2019. We analysed the characteristics of patients and outcomes, including mortality, according to the type of clinical indication for outpatient care (general cardiology, perioperative evaluation and follow-up and treatment cardiotoxicity).

RESULTS

From a total of 26,435 medical consultations, we obtained the data of 4535 individuals among the medical care outpatients. When we analysed the clinical characteristics of patients considering the clinical indication - general cardiology, perioperative evaluation and cardiotoxicity outpatient clinics, differences were observed with respect to age (59 [48-66], 66 [58-74] and 69 [62-76], p < 0.001), diabetes (67 [15%], 635 [22.6%] and 379 [29.8%]; p < 0.001), hypertension (196 [43.8%], 1649 [58.7%] and 890 [70.1%], p < 0.001) and dyslipidaemia (87 [19.7%), 735 [26.2%] and 459 [36.2%], p < 0.001). A similar overall mortality rate was observed in the groups (47.5% vs. 45.7% vs. 44.9% [p = 0.650]).

CONCLUSION

The number of oncologic patients in the Cardio-Oncology Programme has grown in the last decade. A well-structured cardio-oncology programme is the key to achieving the true essence of this area, namely, ongoing care for cancer patients throughout the disease treatment process, optimizing their cardiovascular status to ensure they can receive the best therapy against cancer.

摘要

背景

近年来,肿瘤心脏病学领域在全球范围内得到了发展,为癌症患者的生存和生活质量带来了益处。本研究报告了巴西大学癌症医院开展的一项开创性肿瘤心脏病学项目的 10 年经验,描述了患者的临床特征和临床结局。

方法

对 2009 年 4 月至 2019 年 2 月期间在肿瘤心脏病学项目中接受治疗的患者队列进行回顾性研究。我们分析了患者的特征和结局,包括死亡率,并根据门诊治疗的临床指征(普通心脏病学、围手术期评估和随访以及治疗性心脏毒性)进行分类。

结果

在总共 26435 次医疗咨询中,我们从门诊患者中获得了 4535 名个体的数据。当我们根据临床指征(普通心脏病学、围手术期评估和心脏毒性门诊)分析患者的临床特征时,观察到年龄(59 [48-66]、66 [58-74]和 69 [62-76],p<0.001)、糖尿病(67 [15%]、635 [22.6%]和 379 [29.8%];p<0.001)、高血压(196 [43.8%]、1649 [58.7%]和 890 [70.1%],p<0.001)和血脂异常(87 [19.7%]、735 [26.2%]和 459 [36.2%],p<0.001)存在差异。在这些组中观察到相似的总体死亡率(47.5%比 45.7%比 44.9% [p=0.650])。

结论

在过去十年中,肿瘤心脏病学项目中的肿瘤患者数量有所增加。一个结构良好的肿瘤心脏病学项目是实现该领域真正本质的关键,即对癌症患者进行全程护理,优化其心血管状况,确保他们能够接受最佳的癌症治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c8f/7189468/93855fe8359f/12872_2020_1471_Fig1_HTML.jpg

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