放射性心脏损伤:现状与挑战

Radiation-Induced Heart Disease:Current Status and Challenges

放射治疗(放疗)作为目前恶性肿瘤的主要治疗手段之一,尤其在胸部肿瘤的多学科综合治疗中发挥着重要作用。随着放疗技术的发展,研究重点已经从提高恶性肿瘤患者整体生存率转为降低放射性相关损伤的发生率。目前,放射性心脏损伤(radiation-induced heart disease,RIHD)已成为胸部肿瘤放疗患者非癌性死亡的主要原因之一,严重影响患者的生存质量和临床预后。近年来,RIHD的发病机制逐渐被阐明,并提出了一些预防和治疗RIHD的潜在手段。本文结合现阶段已报道的RIHD临床表现和病理改变,综述其生物学机制和潜在治疗方案,并指出当前RIHD防治工作中存在的挑战,为预防和治疗RIHD提供参考。

Being one of the major therapeutic measures for malignant tumors,radiation therapy,or radiotherapy,plays a particularly crucial role in the multidisciplinary integrated treatment of thoracic tumors.With the development in radiotherapy technology,the research focus has shifted from improving the overall survival of malignant tumor patients to reducing the incidence of radiation-related injuries.Currently,radiation-induced heart disease(RIHD)has become one of the leading non-cancer causes of death in thoracic tumor patients who have undergone radiotherapy,seriously affecting their quality of life and clinical prognosis.In recent years,there has been growing understanding of the pathogenesis of RIHD,and proposals have been made for some potential measures for the prevention and treatment of RIHD.Based on the clinical manifestations and pathological changes of RIHD that have been reported,we herein reviewed the biological mechanism and potential treatment options for RIHD.We also discussed existing challenges in the prevention and treatment of RIHD,intending to provide references for the prevention and treatment of RIHD.