Anthracycline Chemotherapy and Cardiotoxicity.
Anthracycline Chemotherapy and Cardiotoxicity.
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DOI：
10.1007/s10557-016-6711-0
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发表时间：
2017-02
影响因子：
3.4
通讯作者：
Yellon DM
中科院分区：
文献类型：
--
作者：
McGowan JV;Chung R;Maulik A;Piotrowska I;Walker JM;Yellon DM
蒽环类药物化疗在治疗许多形式的癌症中保持着突出的作用。无毒副作用限制了它们的剂量，并且改善了癌症结果，使癌症幸存者暴露于增加的心血管发病率和死亡率。心脏毒性的基本机制可能涉及活性氧生成和拓扑异构酶2的直接途径以及其他间接途径。神经保护性治疗很少，已经检查的治疗包括肾素血管紧张素系统阻断剂、β受体阻滞剂或铁螯合剂右雷佐生。利用ErbB或其他新的促生存途径的新治疗方法，如条件反射，正处于心脏保护的地平线上。即使在即将到来的癌症靶向治疗时代，今天接受蒽环类药物治疗的癌症患者中的相当大一部分可能成为明天的心脏病患者。
Anthracycline chemotherapy maintains a prominent role in treating many forms of cancer. Cardiotoxic side effects limit their dosing and improved cancer outcomes expose the cancer survivor to increased cardiovascular morbidity and mortality. The basic mechanisms of cardiotoxicity may involve direct pathways for reactive oxygen species generation and topoisomerase 2 as well as other indirect pathways. Cardioprotective treatments are few and those that have been examined include renin angiotensin system blockade, beta blockers, or the iron chelator dexrazoxane. New treatments exploiting the ErbB or other novel pro-survival pathways, such as conditioning, are on the cardioprotection horizon. Even in the forthcoming era of targeted cancer therapies, the substantial proportion of today’s anthracycline-treated cancer patients may become tomorrow’s cardiac patient.