Hedayati E, Papakonstantinou A, Månsson-Broberg A, Bergh J, Hubbert L, Altena R
Department of Oncology and Pathology Cancer Center Karolinska, Karolinska Institutet, Stockholm, Sweden.
Medical unit breast, endocrine tumors and sarcoma, Theme Cancer, Karolinska University Hospital Stockholm, Solna, Sweden.
Cardiooncology. 2020 Sep 1;6:16. doi: 10.1186/s40959-020-00070-y. eCollection 2020.
In cardio-oncology, a range of clinical dilemmas can be identified where high-quality evidence for management is still lacking. The aim of this project was to study clinical practices and expert approaches to several clinical cardio-oncological dilemmas regarding prediction, prevention and treatment of cardiovascular disease in adult cancer patients.
A cross-sectional online survey was sent out to internationally renowned experts in the field of cardio-oncology. Participants were selected based on being first or last authors of papers in the field of cardio-oncology, or principal investigators to trials in this field.
Topics discussed include, among others, the use of biomarkers for subclinical cardiovascular toxicity, approaches towards primary prevention and follow-up with medication and life-style recommendations, and management of fluoropyrimidine-vasospasm, QTc-prolongation and asymptomatic declines in left ventricular ejection fraction.
The answers provided in this survey have shed light on expert-based practices in cardio-oncologic dilemmas. Attitudes towards, as well as discrepancies in those dilemmas are presented. Existing discrepancies clearly indicate the need for generation of high-quality data that allows for more evidence-based recommendations in the future.
在心脏肿瘤学领域，存在一系列临床难题，目前仍缺乏高质量的管理证据。本项目旨在研究针对成年癌症患者心血管疾病预测、预防和治疗等若干心脏肿瘤学临床难题的临床实践和专家方法。
向心脏肿瘤学领域的国际知名专家开展了一项横断面在线调查。参与者的入选标准为是心脏肿瘤学领域论文的第一作者或最后作者，或者是该领域试验的主要研究者。
讨论的主题包括，使用生物标志物评估亚临床心血管毒性、一级预防方法以及药物和生活方式建议的随访，以及氟尿嘧啶血管痉挛、QTc延长和左心室射血分数无症状下降的管理。
本次调查提供的答案揭示了心脏肿瘤学难题中基于专家的实践情况。展示了对这些难题的态度以及存在的差异。现有的差异清楚地表明需要生成高质量数据，以便未来能有更多基于证据的建议。
