National Scientific Center «The M.D. Strazhesko Institute of Cardiology», 5 Narodnoho Opolchennia Str., Kyiv, 03680, Ukraine.
National Cancer Institute of the Ministry of Health of Ukraine, 33/43 Lomonosova Str., Kyiv, 03022, Ukraine.
Probl Radiac Med Radiobiol. 2021 Dec;26:498-512. doi: 10.33145/2304-8336-2021-26-498-512.
Breast cancer patients receive combined antitumor treatment (surgery, chemotherapy, targeted drugs and radia-tion), so they are considered to be the patients with potentially high risk of cardiotoxicity (CT). Risk stratificationof cardiovascular complications before the beginning and during the cancer treatment is an important issue.
to develop a CT risk model score taking into account cardiological, oncological and individual risks.
The study included 52 breast cancer patients with retrospective analysis of their medicalhistory, risk factors, and echocardiographic parameters before the onset and in 12 months follow up. Based on theanalysis of the data, a CT risk model score was developed and recommended. The patients were divided into groupsaccording to the score: Group 1 - low risk of CT development - score < 4 points, Group 2 - moderate risk - 5-7points, Group 3 - high risk > 8 points. According to the scale, BC patients with a total of > 8 points are consideredto be at high risk for CT complications. Radiation therapy and anthracyclines, as well as associated cardiovasculardiseases were the most important risk factors of CT.
Based on the study of retrospective analysis of risk factors, data of heart function monitoring during follow-up,the risk model score of cardiotoxicity has been developed for the BC patients' stratification. According to the proposedscore risk model, BC patients with a total score of > 8 points considered to have high risk of cardiotoxic complications.
Using of the proposed risk model score with calculation of CT risk factors both before the beginningand during cancer therapy is important, because it allows predicting the risk of CT development - to identify high-risk patients, accordingly, to develop an individualized plan for cardiac function monitoring and to start timely cardioprotective therapy.
乳腺癌患者接受联合抗肿瘤治疗(手术、化疗、靶向药物和放疗),因此被认为是潜在心毒性(CT)风险较高的患者。在癌症治疗开始前和治疗期间对心血管并发症的风险进行分层是一个重要的问题。
制定一种 CT 风险模型评分,考虑到心血管、肿瘤学和个体风险。
本研究纳入了 52 例乳腺癌患者,对其病史、危险因素以及发病前和 12 个月随访期间的超声心动图参数进行回顾性分析。基于数据分析,制定并推荐了 CT 风险模型评分。根据评分将患者分为三组:组 1-CT 发展风险低-评分<4 分,组 2-中度风险-5-7 分,组 3-高风险>8 分。根据该评分标准,BC 患者总评分>8 分被认为 CT 并发症风险较高。放射治疗和蒽环类药物以及相关心血管疾病是 CT 的最重要危险因素。
基于对危险因素的回顾性分析研究、随访期间心脏功能监测数据,为 BC 患者分层制定了 CT 毒性风险模型评分。根据提出的评分风险模型,总评分>8 分的 BC 患者被认为有发生 CT 毒性并发症的高风险。
在癌症治疗开始前和治疗期间使用计算 CT 风险因素的建议风险模型评分很重要,因为它可以预测 CT 发展的风险-识别高危患者,相应地制定个体化的心脏功能监测计划,并及时开始心脏保护治疗。