Br J Cancer:顺铂治疗加速睾丸癌幸存者的血管老化

2020-09-19 xiaozeng MedSci原创

睾丸癌(TC)虽然仅占男性所有癌症的1%,却是影响15至35岁男性的最常见的实体瘤。根据疾病的分期,一般采取睾丸切除术或切除术结合放疗(RT)、铂类药物化疗(CT)的方式进行治疗。至顺铂(cispla

睾丸癌(TC)虽然仅占男性所有癌症的1%,却是影响15至35岁男性的最常见的实体瘤。根据疾病的分期,一般采取睾丸切除术或切除术结合放疗(RT)、铂类药物化疗(CT)的方式进行治疗。至顺铂(cisplatin)作为治疗药物后,TC的生存率有所提高,患者的10年生存率达到90-95%。然而,受不良后期治疗效果的影响,患者二次发病率升高。

基于顺铂的化疗策略对睾丸癌幸存者(TCS)的影响包括血管疾病的发病率,但目前尚无治疗20年后的数据。该研究旨在评估长时间段内TCS患者的血管损伤情况。

研究流程图

研究人员通过募集TCS患者(仅接受化疗或睾丸切除术治疗)和年龄匹配的健康对照组。通过超声测量颈股脉搏波速度(cf-PWV)来评估血管硬化程度。

化疗组与对照组cf-PWV随年龄变化曲线

研究人员共招募127个TCS患者,包括化疗组(70例)和睾丸切除术组(57例)以及70个健康对照。随访中位时间为28年(范围为20-42年)。结果显示,TCS患者中的cf-PWV(m/s)高于对照组(平均值8.05对7.60)。化疗组的cf-PWV高于睾丸切除术组(平均值8.39对7.61)。随着年龄的增长,化疗组的cf-PWV相比于对照组升高得更快(回归系数 7.59×10-3对4.04×10-3)。


综上,该研究结果显示,基于顺铂的化疗策略治疗的睾丸癌幸存者显示出随年龄增长的血管损伤增加并伴随着血管的加速老化,且存在心血管疾病发病风险,建议对该类患者加强心血管疾病风险管理

 

原始出处:

Stelwagen, J., Lubberts, S., Steggink, L.C. et al. Vascular aging in long-term survivors of testicular cancer more than 20 years after treatment with cisplatin-based chemotherapy. Br J Cancer (14 September 2020).

 

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    2020-09-21 zhangph
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