化疗药物所致的心脏毒性的监测及防治
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摘要
恶性肿瘤仍是当今人类医学需攻克的难题之一。外科手术、化疗和放疗等多种抗肿瘤治疗方式的联合应用,使癌症患者的预后及远期生存率有了很大的改善,但同时也带来了化疗所致的心血管不良事件。蒽环类化疗药物的心脏毒性众所周知,相应的机制也一度成为研究的热门,同样非蒽环类对心脏的损害亦不容忽视,可惜的是在研究及临床工作中并未引起足够重视。现针对各类化疗药物可能导致的心脏毒性、评估手段及防治做一综述,以期为临床应用提供更多借鉴。
Cancer tumor is one of a huge challenge to human medicine today.Combination of surgery,chemotherapy and radiotherapy and other anti-tumor treatment,has dramatically improved the prognosis of cancer patients and long-term survival rate,but at the same time it brought cardiovascular adverse events caused by chemotherapy.Anthracycline cardiotoxicity is well-known,and corresponding mechanism had become a research hotspot.However,the damage to the heart of gnonanthracycline cardiotoxicity should not to be ignored.Unfortunately it did not attach close attention in research and clinical work.Aiming at all kinds of chemotherapy drugs which cause cardiotoxicity,assessment method and therapy is summarized,in order to provide more reference for clinical medicine.
Cancer tumor is one of a huge challenge to human medicine today.Combination of surgery,chemotherapy and radiotherapy and other anti-tumor treatment,has dramatically improved the prognosis of cancer patients and long-term survival rate,but at the same time it brought cardiovascular adverse events caused by chemotherapy.Anthracycline cardiotoxicity is well-known,and corresponding mechanism had become a research hotspot.However,the damage to the heart of gnonanthracycline cardiotoxicity should not to be ignored.Unfortunately it did not attach close attention in research and clinical work.Aiming at all kinds of chemotherapy drugs which cause cardiotoxicity,assessment method and therapy is summarized,in order to provide more reference for clinical medicine.
引文
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[19]Xing M,Yan F,Yu S,et al.Efficacy and cardiotoxicity of liposomal doxorubicinbased chemotherapy in advanced breast cancer:a meta-analysis of ten randomized controlled trials[J].PLo S One,2015,10(7):e0133569.
[20]Lipshultz SE,Sambatakos P,Maguire M,et al.Cardiotoxicity and cardioprotection in childhood cancer[J].Acta Haematol,2014,132(3-4):391-399.
[21]Dillenburg RF,Nathan P,Mertens L.Educational paper:decreasing the burden of cardiovascular disease in childhood cancer survivors:an update for the pediatrician[J].Eur J Pediatr,2013,172(9):1149-1160.
[22]庞缨,陈军初,谢玮,等.右内亚胺对柔红霉素所致的心脏毒性的防治作用[J].广东医学,2012,32(12):1606-1607.
[23]Oliva S,Cioffi G,Frattini S,et al.Administration of angiotensin-converting enzyme inhibitors andβ-blockers during adjuvant trastuzumab chemotherapy for nonmetastatic breast cancer:marker of risk or cardioprotection in the real world?[J].Oncologist,2012,17(7):917-924.
[24]EI-Boghdady NA.Increased cardiac endothelin-1 and nitric oxide in adriamycininduced acute cardiotoxicity:protective effect of Ginkgo biloba extract[J].Indian J Biophys,2013,50(3):202-209.
[2]Kucharska W,Negrusz-Kawecka M,Cromkowska M,et al.Cardiotoxicity of oncological treatment in children[J].Adv Clin Exp Med,2012,21(3):281-288.
[3]Heger Z,Rodrigo MA,Krizkova S,et al.Metallothionein as a scavenger of free radicals—New cardioprotective therapeutic agent or initiator of tumor chemoresistance?[J].Curr Drug Targets,2016,17(12):1438-1451.
[4]Reis-Mendes AF,Sousa E,de Lourdes Bastos M,et al.The role of the metabolism of anticancer drugs in their induced-cardiotoxicity[J].Curr Drug Metab,2015,17(1):75-90.
[5]Demkow U,Stelmaszczyk-Emmel A.Cardiotoxicity of cisplatin-based chemotherapy in advanced non-small cell lung cancer patients[J].Respir Physiol Neurobiol,2013,187(1):64-67.
[6]Keller GA,Ponte ML,di Girolamo G.Other drugs acting on nervous system associated with QT-interval prolongation[J].Curr Drug Saf,2010,5(1):105-111.
[7]Hasinoff BB,Patel D,Wu X.The dual-targeted HER1/HER2 tyrosine kinase inhibitor lapatinib strongly potentiates the cardiac myocyte-damaging effects of doxorubicin[J].Cardiovasc Toxicol,2013,13(1):33-47.
[8]van Hasselt JG,Boekhout AH,Beijnen JH,et al.Population pharmacokineticpharmacodynamic analysis of tratuzumab-associated cardiotoxicity[J].Clin Pharmacol Ther,2011,90(1):126-132.
[9]Reagan WJ,York M,Berridge B,et al.Comparison of cardiac troponin I and T,including the evaluation of an ultrasensitive assay,as indicators of doxorubicininduced cardiotoxicity[J].Toxicol Pathol,2013,41(8):1146.
[10]Reiter M,Twerenbold R,Reichlin T,et al.Early diagnosis of acute myocardial infarction in the elderly using more sensitive cardiac troponin assays[J].Eur Heart J,2011,32(11):1379-1389.
[11]Curigliano G,Cardinale D,Suter T,et al.Cardiovascular toxicity induced by chemotherapy,targeted agents and radiotherapy:ESMO Clinical Practice Guidelines[J].Ann Oncal,2012,23(Suppl 7):vii155-166.
[12]段利科,李玲,谢明星,等.超声三维斑点追踪技术评价慢性心功能不全患者左室旋转及扭转运动的初步研究[J].中国超声医学杂志,2011,27(1):30-34.
[13]侯翠,丁粤粤,王辉,等.二维斑点追踪成像技术评价急性淋巴细胞白血病患儿柔红霉素化疗后左心室功能的价值[J].临床超声医学杂志,2016,18(1):25-28.
[14]崔洪岩,礼广森,张宇,等.斑点追踪成像技术评价表阿霉素对乳腺癌患者左心室心肌纵向分层应变的影响[J].中国介入影像与治疗学,2016,13(12):753-756.
[15]de Geus-Oei LF,Mavinkurve-Groothuis AM,Bellersen L,et al.Scintigraphic techniques for early detection of cancer treatment-induced cardiotoxicity[J].Nucl Med Technol,2013,41(3):170-181.
[16]中国临床肿瘤学会(CSCO),中华血液学会,哈尔滨血液病肿瘤研究所.防治蒽环类抗肿瘤药物心脏毒性的中国专家共识(2011版)[J].临床肿瘤杂志,2011,16(12):1122-1129.
[17]Hochberg JC,Cairo MS,Friedman DM.Cardio-oncology issues among pediatric cancer and stem cell transplant survivors[J].Cardiol Rev,2014,22(6):268-274.
[18]谭慧,杨润祥,罗春香,等.心肌定量组织速度成像技术评价表阿霉素微量泵入与静脉输注的心脏毒性[J].肿瘤防治研究,2010,37(3):324-325.
[19]Xing M,Yan F,Yu S,et al.Efficacy and cardiotoxicity of liposomal doxorubicinbased chemotherapy in advanced breast cancer:a meta-analysis of ten randomized controlled trials[J].PLo S One,2015,10(7):e0133569.
[20]Lipshultz SE,Sambatakos P,Maguire M,et al.Cardiotoxicity and cardioprotection in childhood cancer[J].Acta Haematol,2014,132(3-4):391-399.
[21]Dillenburg RF,Nathan P,Mertens L.Educational paper:decreasing the burden of cardiovascular disease in childhood cancer survivors:an update for the pediatrician[J].Eur J Pediatr,2013,172(9):1149-1160.
[22]庞缨,陈军初,谢玮,等.右内亚胺对柔红霉素所致的心脏毒性的防治作用[J].广东医学,2012,32(12):1606-1607.
[23]Oliva S,Cioffi G,Frattini S,et al.Administration of angiotensin-converting enzyme inhibitors andβ-blockers during adjuvant trastuzumab chemotherapy for nonmetastatic breast cancer:marker of risk or cardioprotection in the real world?[J].Oncologist,2012,17(7):917-924.
[24]EI-Boghdady NA.Increased cardiac endothelin-1 and nitric oxide in adriamycininduced acute cardiotoxicity:protective effect of Ginkgo biloba extract[J].Indian J Biophys,2013,50(3):202-209.