Mitchell Joshua D, Cehic Daniel A, Morgia Marita, Bergom Carmen, Toohey Joanne, Guerrero Patricia A, Ferencik Maros, Kikuchi Robin, Carver Joseph R, Zaha Vlad G, Alvarez-Cardona Jose A, Szmit Sebastian, Daniele Andrés J, Lopez-Mattei Juan, Zhang Lili, Herrmann Jörg, Nohria Anju, Lenihan Daniel J, Dent Susan F
Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, Missouri, USA.
GenesisCare, Australia.
JACC CardioOncol. 2021 Sep 21;3(3):360-380. doi: 10.1016/j.jaccao.2021.06.003. eCollection 2021 Sep.
Radiation therapy is a cornerstone of cancer therapy, with >50% of patients undergoing therapeutic radiation. As a result of widespread use and improved survival, there is increasing focus on the potential long-term effects of ionizing radiation, especially cardiovascular toxicity. Radiation therapy can lead to atherosclerosis of the vasculature as well as valvular, myocardial, and pericardial dysfunction. We present a consensus statement from the International Cardio-Oncology Society based on general principles of radiotherapy delivery and cardiovascular risk assessment and risk mitigation in this population. Anatomical-based recommendations for cardiovascular management and follow-up are provided, and a priority is given to the early detection of atherosclerotic vascular disease on imaging to help guide preventive therapy. Unique management considerations in radiation-induced cardiovascular disease are also discussed. Recommendations are based on the most current literature and represent a unanimous consensus by the multidisciplinary expert panel.
放射治疗是癌症治疗的基石，超过50%的患者接受放射治疗。由于其广泛应用和患者生存率提高，人们越来越关注电离辐射的潜在长期影响，尤其是心血管毒性。放射治疗可导致血管动脉粥样硬化以及瓣膜、心肌和心包功能障碍。我们展示了国际心脏肿瘤学会基于放疗实施的一般原则以及该人群心血管风险评估和风险缓解的共识声明。提供了基于解剖学的心血管管理和随访建议，重点是通过影像学早期发现动脉粥样硬化性血管疾病以指导预防性治疗。还讨论了放射诱发的心血管疾病的独特管理考量。这些建议基于最新文献，代表了多学科专家小组的一致共识。
