摘要
乳腺癌和心血管疾病是现代社会的两大“杀手”,严重威胁着中国女性的健康,目前两个学科之间关联共性尚未引起临床医师足够的重视,为相关的跨学科合作实践带来一定困难。因此,对于那些已存在心血管系统疾病或心血管疾病风险的乳腺癌患者,临床医师在进行相关抗肿瘤诊疗时,应用类似乳腺癌干预策略的方法来综合评估相关风险,进行相关心脏毒性的预防及治疗干预。目前不少发达国家,已经建立了肿瘤心脏病专科门诊、病房和对应的多学科治疗团队(multidisciplinary treatment teams,MDT)。而在国内,相关学科发展才刚刚开始。可以预见的是,随着乳腺癌检测和治疗手段的不断进步,会有越来越多的乳腺癌患者获得长期的生存,这意味着其中部分患者必然要面临抗肿瘤治疗相关心脏毒性所带来的并发症的风险。因此,一份具有强有力循证医学证据支持的相关指南和临床共识能够为临床医师提供针对性的随访、监测、治疗流程和有效的管理手段,具有十分重要的临床指导意义。本共识旨在指导临床医师对乳腺癌患者进行相关抗肿瘤治疗(化疗、靶向治疗、手术、内分泌治疗、免疫治疗及放疗)的前提下,将心脏保护作为一个整体进行评估和监测,根据监测的结果决定后续干预手段,并决定是否及何时由心脏科医师进行专业会诊,避免因对乳腺癌相关心脏毒性认识不够,导致治疗不及时产生相关不良后果,为中国乳腺癌心脏病诊疗防治提供一份切实可行的临床实践操作流程,最终为改善中国乳腺癌患者的预后作出贡献。
Recent advances in the medical oncological treatment options for cancer have led to a clear improvement in the survival rate worldwide;however, many of the recently developed new drugs are directly or indirectly associated with cardiovascular side effects. Cardiovascular diseases are already the most frequent non-cancerous cause of death in tumor patients. Prevention and early detection of these complications, correct management and timely initiation of specific cardiac medical treatment are the keys to improvement of the cardiovascular prognosis. At present, many developed countries have established oncology-cardiology specialist clinics, wards and related multidisciplinary teams(MDT). In our country, development of cardio-oncology has just on the way. With improvement of survival of breast cancer patients, it is reasonable to foresee that more and more breast cancer patients might suffer from cardiovascular disease, which indicates that it is necessary to focus on risk associated with antitumor therapyrelated cardiotoxicity. Therefore, an elaborate guideline supported by solid medical evidence is strongly needed for clinicians major in oncology. This consensus provides an overview and comprehensive summary of the possible cardiotoxic side effects of important oncological therapies and offers possible practical strategies with respect to risk stratification, cardiological follow-up care and management approaches for chemotherapy-induced left ventricular dysfunction. We believe this consensus will provide a practical clinical procedures for treatment and prevention of cardio-oncology in breast cancer in China, and make contributions to improvement of outcome of cardiotoxicity in Chinese breast cancer patients.
作者
沈赞
邵志敏
中华医学会肿瘤学分会肿瘤支持康复治疗学组
中国乳腺癌相关心脏病诊疗共识编写委员会
SHEN Zan;SHAO Zhimin;Cancer Support Rehabilitation Therapy Group of Chinese Medical Association Oncology Branch;the Drafting Committee of China Breast Cancer Related Heart Disease Diagnosis and Treatment Consensus(Department of Oncology,Affiliated Sixth People's Hospital,Shanghai Jiao Tong University,Shanghai,200233,China;Department of Breast Surgery,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;不详)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2022年第10期1016-1036,共21页
China Oncology
关键词
乳腺癌
肿瘤心脏病学
预防
治疗
Breast cancer
Cardio-oncology
Prevention
Treatment
