Int J Cardiol:蒽环类和曲妥珠单抗治疗乳腺癌后心脏效应的晚期特征!

2018-03-09 xing.T MedSci原创

由此可见,使用先进的CMR,当代化疗方案表现出最小的长期心脏毒性。这项研究表明这些患者在化疗12个月后应限制系列成像检查。

蒽环类抗生素(A)和曲妥珠单抗(T)化疗已被公认具有心脏毒性,可能导致显著的发病率和死亡率。近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员先前对46个前瞻性招募地乳腺癌患者的研究显示在1个月和3个月早期左心室(LV)和右室(RV)功能下降,但在12个月只有持续的 RV功能障碍,与化疗药治疗后观察到的早期(1个月和3个 月)心肌水肿相关。

为了探讨晚期心脏效应,同一队列采用先进的心血管磁共振(CMR)成像检查在化疗后5±1年重新成像,包括T1映射。

46例患者中有26例(50%)患者接受了随访成像。从基线到5 年,从统计学而非临床上可观察到左室射血分数(EF)显著降低(72.2 ± 6.6到65.4 ± 9.3,P<0.005)。从初始到3个月(n=5)或12个月(n=3)LVEF下降>10%的受试者在5 年时LV或RVEF之间没有任何差异。心肌水肿与5 年时LV或RVEF之间无相关性。在5 年,整体T1值均处于正常范围内(935 ± 48 ms)。一名病人T1值明显升高(>1000ms)与LV或RVEF没有显著相关性。

由此可见,使用先进的CMR,当代化疗方案表现出最小的长期心脏毒性。这项研究表明这些患者在化疗12个月后应限制系列成像检查。

原始出处:

Ashlee Kimball,et al. Late characterisation of cardiac effects following anthracycline and trastuzumab treatment in breast cancer patients.International Journal of Cardiology.2018. https://doi.org/10.1016/j.ijcard.2018.03.025

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    2018-03-14 Drhzm308

    谢谢.学习了

    0

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level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Mar 10 15:04:15 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294535, encodeId=021229453545, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Fri Mar 09 12:54:42 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294516, encodeId=d1dd29451611, content=好好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Mar 09 12:16:43 CST 2018, time=2018-03-09, status=1, ipAttribution=)]
    2018-03-13 lietome2

    好文.值得点赞!认真学习.应用于实践!谢谢分享给广大同好!

    0

  5. 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level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Mar 10 15:04:15 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294535, encodeId=021229453545, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Fri Mar 09 12:54:42 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294516, encodeId=d1dd29451611, content=好好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Mar 09 12:16:43 CST 2018, time=2018-03-09, status=1, ipAttribution=)]
    2018-03-11 大爰

    学习了谢谢分享!!

    0

  6. 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level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Mar 10 15:04:15 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294535, encodeId=021229453545, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Fri Mar 09 12:54:42 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294516, encodeId=d1dd29451611, content=好好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Mar 09 12:16:43 CST 2018, time=2018-03-09, status=1, ipAttribution=)]
    2018-03-10 sunfeifeiyang

    0

  8. 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level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Mar 10 15:04:15 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294535, encodeId=021229453545, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Fri Mar 09 12:54:42 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294516, encodeId=d1dd29451611, content=好好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Mar 09 12:16:43 CST 2018, time=2018-03-09, status=1, ipAttribution=)]
    2018-03-10 神功盖世

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1781882, encodeId=ee641e818827b, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Jun 07 08:10:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648121, encodeId=63701648121b9, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, 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level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Mar 10 15:04:15 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294535, encodeId=021229453545, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Fri Mar 09 12:54:42 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294516, encodeId=d1dd29451611, content=好好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Mar 09 12:16:43 CST 2018, time=2018-03-09, status=1, ipAttribution=)]
    2018-03-09 神功盖世

    0

  10. 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content=好好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Mar 09 12:16:43 CST 2018, time=2018-03-09, status=1, ipAttribution=)]
    2018-03-09 忠诚向上

    好好好学习天天向上

    0

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蒽环类药物心脏毒性保护剂临床应用的热点问题

Ann Onco:FOXP3表达示蒽环类抗乳腺癌效果

  法国学者3月19日在线发表于《肿瘤学年鉴》(Annals of Oncology)的一项研究表明,乳腺癌细胞POXP3表达状态可能可以精确预测蒽环类抗乳腺癌效果。   该研究显示,乳腺癌细胞表达FOXP3与较好的总生存(OS)状况相关(P=0.003)。   单变量和多变量分析显示,乳腺癌细胞表达FOXP3与接受蒽环类为基础辅助化疗而非蒽环类-紫杉烷序贯化疗的患者较好的OS状态具有独立相关

JNCI:蒽环类与曲妥珠单抗带来心脏衰竭风险

    临床试验结果已经显示,乳腺癌患者接受蒽环类和曲妥珠单抗(赫赛汀,罗氏)的治疗会增加心力衰竭和心肌病的风险。但是在临床试验之外的患者人群中,治疗与风险的关系是怎样?一项研究结果表明:在“现实世界”的观察性队列研究能够表明这样的风险可能会更高。该研究发表于8月31日美国国家癌症研究所杂志。     中位随访时间比之前的临床试验延长了

JAHA:接受蒽环类化疗的儿童和年轻成人心脏毒性的潜在标志物

在这个研究中,ACs治疗后会出现心脏相关的血浆miRNA失调。AC治疗后血浆中miR-29b和miR-499会急性升高,并可以观察到蒽环类药物剂量和心肌损伤标志物存在量效关系。进一步评估miRNAs可能为AC诱导的心脏毒性的机制提供了新视角,并得到通过早期干预来减轻心脏毒性的生物标志物。

蒽环类药物心脏毒性防治共识

蒽环类药物心脏毒性防治共识