Cheng Kai-Hung, Wu Yen-Wen, Hou Charles Jia-Yin, Hung Chao-Ming
Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital.
College of Medicine, I-Shou University, Kaohsiung.
Acta Cardiol Sin. 2021 Sep;37(5):457-463. doi: 10.6515/ACS.202109_37(5).20210706A.
Advances in cancer treatments have led to an increasing number of cancer survivors, but also high rates of short- and long-term cardiovascular (CV) toxicities. The number of new cancer drugs is constantly increasing, and the uncertain CV toxicities of these drugs make long-term care and monitoring difficult. Moreover, traditional type I and type II cardiotoxicities may not be applicable to all of these agents. Multidisciplinary care with expertise in oncology, cardiology and other related specialties is required to mitigate cancer therapeutics-related cardiovascular dysfunction (CTRCD). The aim of this review is to provide an overview of the main CTRCD, risk assessment, early diagnosis, and strategies for the prevention and management of patients receiving cancer therapies. There are still unmet needs for cardio- oncology researchers with regards to early detection measures, better treatment strategies, better follow-up protocols, and better management of CTRCD. Experts in cardiology, oncology, hematology, and radio-oncology should thus work closely in an attempt to foster patient awareness and research in this field, as well as call for support from public and industrial sources to initiate pivotal clinical trials to solve these unmet needs.
癌症治疗的进展使癌症幸存者的数量不断增加，但短期和长期心血管毒性的发生率也很高。新型癌症药物的数量在不断增加，而这些药物不确定的心血管毒性使得长期护理和监测变得困难。此外，传统的I型和II型心脏毒性可能并不适用于所有这些药物。需要肿瘤学、心脏病学和其他相关专业的多学科护理，以减轻癌症治疗相关的心血管功能障碍（CTRCD）。本综述的目的是概述接受癌症治疗患者的主要CTRCD、风险评估、早期诊断以及预防和管理策略。在早期检测措施、更好的治疗策略、更好的随访方案以及CTRCD的更好管理方面，心血管肿瘤学研究人员仍有未满足需求。因此，心脏病学、肿瘤学及血液学、放射肿瘤学专家应密切合作，以提高患者对该领域的认识并推动相关研究，同时呼吁公共和产业界提供支持，启动关键临床试验以解决这些未满足需求。
