摘要
0引言 肿瘤心脏病学是一门研究肿瘤患者心血管疾病的医学学科。近几十年来,尽管在恶性肿瘤性疾病及心脏病的预防、早期诊断和治疗水平取得了显著的进展,这两类疾病仍然构成了发展中国家最常见的死亡原因。虽然在世界范围内恶性肿瘤仍是高发病率、高死亡率疾病,但是肿瘤患者生存率在近40年都在稳步上升。在1975—1977年间恶性肿瘤患者的5年生存率约50%,1999—2005年间已上升至约68%。仅仅在美国,2014年约有1 450万的肿瘤幸存者,而据估计,至2024年该数值将上升至1 900万。治疗癌症的方法越来越多,但一些方法被证实因存在急性或长期的心血管毒性而影响到患者的生存。从20世纪70年代末到最近几十年,许多研究和课题专注于肿瘤治疗相关的心血管毒性的分子生物学及细胞生物学机制的探讨。70年代至90年代间,研究的重点是与传统化疗药物如蒽环类药物有关的心脏毒性,以及放射治疗后的血管和心包疾病。20世纪末至21世纪初,研究方向转为靶向治疗药如曲妥珠单抗、小分子酪氨酸酶抑制剂等所致的心脏毒性。近3~5年间,我们开始关注免疫治疗药物罕见的、但可能危及生命的心血管相关事件,尤其是免疫检查点抑制剂药物。由于有了这些药物的治疗,使得肿瘤患者预期生存寿命延长,此时心血管毒性变得尤为重要。
0 Introduction Onco-cardiology(also known as Cardio-oncology)is defined as the medical specialty focused on the management of cardiovascular diseases in cancer patients.Significant progress has been achieved in the last several decades in the prevention,early detection,and treatment of both cardiac and oncologic diseases.Despite these advances,these two medical conditions continue to constitute the most common causes of deaths in the developed countries and although cancer remains a leading cause of morbidity and mortality worldwide,the survival rate of patients with malignancy has steadily increased over the last 4 decades.The 5-year relative survival rate of these patients increased from around 50% between 1975 and 1977 to around 68% between 1999 and 2005[1].In the USA alone,around 14.5 million cancer survivors were alive in 2014 and it is estimated that by 2024,the population of cancer survivors will be close to 19 million[2].
作者
Elie Mouhayar
洪翔婵
谭文勇
Elie Mouhayar(Division of Internal Medicine,Department of Cardiology,The University of Texas M.D.Anderson Cancer Center,Houston,TX,USA)
出处
《肿瘤防治研究》
CAS
CSCD
2018年第11期821-830,共10页
Cancer Research on Prevention and Treatment
关键词
肿瘤
化疗
放疗
靶向治疗
心血管毒性
Cancer
Chemotherapy
Radiotherapy
Targeted therapy
Cardiovascular toxicity
