人类表皮生长因子受体2阳性乳腺癌治疗相关心脏毒性的预测因子及模型研究现状

Research status of risk factors and prediction models for cancer therapy-related cardiotoxicity in HER2-positive breast cancer

随着癌症幸存者的增加,心血管疾病已成为肿瘤幸存者继癌症复发转移后的第二大死因。放疗、化疗和靶向治疗的联合应用显著提高了人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)阳性乳腺癌患者的生存率,但射线暴露、化疗药物和靶向药物也带来了不容忽视的心脏毒性。本文通过总结HER2阳性乳腺癌治疗相关心脏毒性的预测因子,介绍现有的心脏毒性风险预测模型,并分析模型的评价效果,以帮助临床医生利用模型来识别高危患者,通过个体化的监测和治疗来减少心脏毒性的发生率,改善患者预后。

In recent years,cardiovascular disease has become the second leading cause of death among cancer survivors after cancer recurrence and metastasis.Combining radiotherapy,chemotherapy and targeted therapy have significantly improved the survival for patients with HER2-positive breast cancer,but radiation exposure,anthracycline-based chemotherapeutic agents and trastuzumab also have posed a non-negligible cardiotoxicity.This article summarizes the predictors of antineoplastic therapy-related cardiotoxicity in HER2-positive breast cancer,describes existing models for predicting the risk of cardiotoxicity and analyses the effectiveness of these models.It is helpful for clinicians to understand the prediction model,identify high-risk patients,minimize cardiotoxicity,and improve the prognosis by individualized monitoring and treatment.