乳腺癌放化疗引起心脏毒性的一级预防进展

Primary Prevention of Cardiotoxicity Caused by Radiotherapy and Chemotherapy for Breast Cancer

女性乳腺癌发病率和死亡率分别位居中国女性恶性肿瘤的第1位和第5位。早期诊断和规范治疗显著减少乳腺癌患者的死亡率,但乳腺癌放化疗的心脏毒性成为其死亡的主要原因之一。早期预防心脏毒性至关重要。现从以下几方面论述:评估心血管疾病风险、放射治疗策略、预防蒽环类药物心脏毒性以及β受体阻滞剂和/或血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体阻滞剂和他汀类药物的心脏保护作用。

The incidence and mortality of breast cancer in women are ranked the 1 st and 5 th in female malignant tumors in China respectively. Early diagnosis and standardized treatment have significantly reduced the mortality of breast cancer patients,but cardiotoxicity of breast cancer with radiotherapy and chemotherapy has become one of the leading causes of death. Early prevention of cardiotoxicity is essential. This review will discuss the following aspects: assessment of cardiovascular disease risk,radiation therapy strategies,prevention of anthracycline cardiotoxicity,beta blocker or/and angiotensin converting enzyme inhibitor/angiotensin Ⅱ receptor blocker and statin cardioprotective effects.