儿童骨肉瘤幸存者心血管事件评估与防治

Assessment and Prevention of Cardiovascular Events in Pediatric Osteosarcoma Survivors

骨肉瘤是儿童常见恶性肿瘤之一,其恶性程度高,易出现肺转移,既往经单纯手术治疗5年生存率不佳。随着多种化疗药物的应用及“术前新辅助化疗+保肢手术+术后辅助化疗”治疗模式的开展,儿童骨肉瘤治愈率明显提高、生存期大幅延长,随之而来骨肉瘤幸存儿童因化疗所致的心血管不良事件发生率和死亡率均急剧增高,成为威胁儿童骨肉瘤幸存者的最大问题。本文针对儿童骨肉瘤治疗中常用化疗药物心脏毒性进行分析并对儿童骨肉瘤幸存者心血管事件评估及防治策略进行综述。

Osteosarcoma is one of the most common malignant tumors in children. It has a high degree of malignancy and is prone to pulmonary metastasis. The 5-year survival rate after simple surgical treatment is poor. As the applications of a variety of chemotherapeutic drugs and neoadjuvant chemotherapy plus limb-salvage surgery plus adjuvant chemotherapy, the cure rate and survival time of children with osteosarcoma have been significantly increased, followed by a sharp increase in the incidence of cardiovascular adverse events and mortality caused by chemotherapy in surviving children with osteosarcoma, which has become the biggest problem threatening the survivors of children with osteosarcoma. This article analyzes the cardiotoxicity of chemotherapy drugs commonly used in the treatment of pediatric osteosarcoma and reviews the assessment of cardiovascular events and prevention strategies for pediatric osteosarcoma survivors.