Cardio-Oncology Service, Royal Brompton Hospital, London, UK.
Cardio-Oncology Service, Royal Brompton Hospital, London, UK.
Clin Oncol (R Coll Radiol). 2021 Aug;33(8):483-493. doi: 10.1016/j.clon.2021.03.012. Epub 2021 Apr 5.
Cardio-oncology is an emerging subspecialty arising from the need for multidisciplinary collaboration to address the increasing prominence of cardiovascular disease (CVD) among cancer patients. This overview outlines the case for establishing cardio-oncology services and defines the ways in which these services benefit cancer patients. The primary objective of cardio-oncology is to manage CVDs in order to allow cancer patients to complete the best cancer treatments safely and with minimal interruption. In the decades since the first discovery of heart failure induced by anthracycline chemotherapy, both cardiovascular and oncological science have advanced considerably. Cardio-oncology services aim to bring together expertise from these two fast moving fields in order to provide optimal evidence-based care for cancer patients with CVDs. Here we discuss the basis of cardio-oncology services by presenting their rationale and key components, as well as their essential roles in education, training and research. At each stage of the cancer care pathway, a cardio-oncology service can add value by ensuring cancer patients have timely access to specialist care backed up by cutting edge diagnostic tools and treatment options, as well as holistic supports. We highlight areas of recent and upcoming developments in the field that are likely to change established clinical practice. Improved cardiac imaging modalities can detect chemotherapy-related cardiac dysfunction earlier and are also essential for the prompt diagnosis of an expanding range of cardiovascular effects complicating newer cancer therapeutics, such as immune checkpoint inhibitors and other targeted therapies. Modern cancer therapy has dramatically improved cancer survival and as such CVD is becoming one of the principal determinants of overall outcome for cancer patients. A dedicated cardio-oncology service can facilitate the optimisation of cardiovascular treatment and enable the completion of cancer therapy. A multidisciplinary collaborative approach is key to achieving these objectives.
心脏肿瘤学是一个新兴的专业领域，源于多学科合作的需求，以解决癌症患者中心血管疾病（CVD）日益突出的问题。本文概述了建立心脏肿瘤学服务的理由，并定义了这些服务使癌症患者受益的方式。心脏肿瘤学的主要目标是管理 CVD，以使癌症患者能够安全地完成最佳癌症治疗，且中断最小。自首次发现蒽环类化疗引起的心力衰竭以来的几十年中，心血管和肿瘤学科学都取得了长足的进步。心脏肿瘤学服务旨在汇集这两个快速发展领域的专业知识，为患有 CVD 的癌症患者提供最佳的循证护理。在这里，我们通过介绍其原理和关键组成部分来讨论心脏肿瘤学服务的基础，以及它们在教育，培训和研究中的重要作用。在癌症治疗路径的每个阶段，心脏肿瘤学服务都可以通过确保癌症患者及时获得专业护理来增加价值，这种护理由尖端的诊断工具和治疗选择以及整体支持来支持。我们强调了该领域最近和即将出现的发展领域，这些领域可能会改变既定的临床实践。改进的心脏成像方式可以更早地发现化疗相关的心脏功能障碍，对于及时诊断新的癌症治疗方法（如免疫检查点抑制剂和其他靶向疗法）引起的一系列心血管效应也至关重要。现代癌症疗法极大地提高了癌症的生存率，因此 CVD 成为癌症患者整体预后的主要决定因素之一。专门的心脏肿瘤学服务可以促进心血管治疗的优化，并使癌症治疗得以完成。多学科合作方法是实现这些目标的关键。
