乳腺癌化疗相关心脏毒性的防治研究进展

Progress in Prevention and Treatment of Cardiotoxicity Associated with Chemotherapy in Breast Cancer

目前,心血管疾病和肿瘤的全球发病率居高不下,有数据显示,截止到2018年,全世界癌症新发总人数约为1810万例,其中,乳腺癌新发例数约为210万,占女性恶性肿瘤发病率和死亡率的首位[1]。近些年,随着我国医疗卫生服务质量和水平的不断提升,包括乳腺癌在内的癌症患者的五年生存率也相应地得到提高,乳腺癌患者整体生存时间整体延长。乳腺癌的治疗方法包括化疗、放疗、靶向治疗以及手术治疗,其中,化疗是主要的治疗手段。值得注意的是,蒽环类等化疗药物的广泛应用,虽有效提高了乳腺癌患者的远期生存率,但同时也不可避免地带来了心律失常、心力衰竭、心肌病等一系列心血管毒性反应,不仅在一定程度上限制了这些药物的临床应用,也对乳腺癌幸存患者的远期预后以及生活质量造成了严重不良影响。因此,乳腺癌化疗相关的心脏毒性有必要引起心血管及肿瘤科医师的警惕和重视,本文现就乳腺癌化疗相关心脏毒性的防治研究进展做一综述。

Currently,the incidence rates of cardiovascular diseases and tumors remain high around the world.It is shown that the total number of new cancer cases worldwide is about 18,100,000 by 2018,of which 2,100,000 are cases of breast cancer that possesses the highest incidence rate and mortality rate among all female malignancies.In recent years,with the continuous improvement of the quality and coverage of medical services in China,the five-year survival rate of cancer patients,including breast cancer,has been improved correspondingly,and the overall survival time of breast cancer patients has been extended as well.The treatments of breast cancer include chemotherapy,radiotherapy,targeted therapy and surgical therapy,and in most cases,chemotherapy is widely accepted.It is worth noting that the extensive application of anthracycline and other chemotherapeutic drugs has effectively improved the long-term survival rate of breast cancer patients,but it also inevitably brings about a series of cardiovascular toxicity reactions such as arrhythmia,heart failure and cardiomyopathy,which not only limits the clinical application of these drugs to a certain extent but also has a serious adverse effect on the long-term prognosis and quality of life of breast cancer survivors.Therefore,it is necessary for cardiologists and oncologists to be vigilant and pay attention to the cardiotoxicity associated with chemotherapy for breast cancer,whose prevention and treatment,together with current progress are reviewed in this article.