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恶性肿瘤是目前社会的主要死亡原因之一,随着抗肿瘤治疗方法的不断进步,癌症患者的生存率显著提高。由于癌症患者的生存期延长,癌症治疗所引起的相关心血管不良事件的发生率明显升高,引起心脏病学家越来越多的关注。抗肿瘤治疗引起的主要心脏毒性包括左室收缩功能障碍和心功能不全,此外还可能产生其他心脏毒性,如高血压、心包疾病、心律失常、血栓栓塞及房颤等。心脏病学家已制定治疗策略,优化检测手段,预防和监测癌症治疗过程中的心脏毒性,以提高患者生活质量。本文主要对抗肿瘤治疗所致常见心脏毒性进行综述。 相似文献
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《中华乳腺病杂志(电子版)》2021,(4)
心血管疾病是女性乳腺癌患者的重要死亡原因。由于乳腺癌与心血管疾病之间存在共同的危险因素、遗传环境,加上抗肿瘤治疗伴随的心脏毒性,女性乳腺癌患者比一般人群发生心血管疾病风险更高。乳腺癌患者的预后与抗肿瘤治疗全程患者的心血管健康状况有关。因此,应该高度关注乳腺癌治疗相关的心血管不良事件,加强一、二级预防。笔者从女性乳腺癌患者与心血管疾病的易感性、治疗影响、危险因素、评估监测方法等方面对其进行了全面总结。 相似文献
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乳腺癌是女性最常见的恶性肿瘤。乳腺癌的靶向治疗越来越受到临床医师的重视,针对不同靶点的靶向治疗通常能使相应的患者从中受益。但是,由于肿瘤细胞靶向治疗药物作用的某些靶点与心血管系统的部分细胞表达的抗原相同,靶向治疗药物在杀灭肿瘤细胞的同时,亦对患者的心血管系统造成损伤,因此,靶向治疗药物的心血管不良反应值得临床医师重视。笔者综述了乳腺癌常用靶向治疗药物心血管不良反应的研究,包括心血管不良反应发生的风险及相关事件等,并强调在相关药物的治疗选择方面,需要考虑发生心血管不良反应的可能性及应对措施,进行靶向治疗时需要对风险和收益进行评估,从而选择最适合的方法,以便更好地监测和预防心血管不良事件,更好地应用靶向药物治疗。 相似文献
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乳腺癌是妇女最常见的癌症,也是癌症所致死亡最常见的原因。2002年,全球有115万妇女确诊为乳腺癌,且约有410000妇女死于乳腺癌。在发达国家,大约75%的乳腺癌发生于绝经后女性,其中80%为激素受体阳性。他莫昔芬一直是绝经后激素受体阳性早期乳腺癌妇女内分泌治疗的首选。不论是否接受过化学治疗, 相似文献
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癌细胞的远处转移是肿瘤发展的最终形式,也是癌症患者死亡的最主要原因。尽管早期乳腺癌患者通过规范化治疗,5年生存率达到了目前的98%;但转移性乳腺癌患者的5年生存率较40年前相比,只是从20%提高到目前的26%, 相似文献
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乳腺癌为女性最常见的恶性肿瘤,是女性癌症相关死亡的第二大原因。乳腺癌缺乏特异性的肿瘤标志物,目前影像学和传统的血清标志物难以及时有效的监测肿瘤的发生发展及耐药的发生,导致临床治疗效果不佳,因此早期诊断、早期治疗提高临床治疗效益,使患者生存率及生活质量提高尤其重要。多项研究证实长链非编码RNA(long non-coding RNA,lncRNA)在乳腺癌中异常表达,并与乳腺癌的发生发展、预后、耐药等密切相关,lncRNA可以作为治疗或是诊断乳腺癌新的生物靶点。本文通过总结lncRNA近年来的研究进展,旨在为乳腺癌的诊治过程提供新的方案。 相似文献
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靶向治疗是选择性作用于肿瘤发生中关键分子的新型抗肿瘤治疗策略。由于最大限度减少了正常细胞的损伤,其与化疗相比具有高效低毒的优势。然而,近年来靶向治疗导致的心血管毒性严重影响患者的预后,因而得到越来越多的重视与关注。临床常见靶向药物的心血管毒性包括心力衰竭、高血压、心律失常、血栓形成等。绝大部分心血管毒性的发生机制仍不是很清楚。在治疗基线完善心血管检查并后续进行密切随访和管理,对常见心血管毒性进行早期预防监测并及早干预对于心脏毒性的防治具有重要意义。 相似文献
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Simon G. Findlay Jason H. Gill Ruth Plummer Carol DeSantis Chris Plummer 《Journal of Geriatric Oncology》2019,10(5):685-689
Survivorship statistics demonstrate that the incidence of cancer continues to rise worldwide, with a further 60% increase in diagnoses predicted by 2030 attributed to lifestyle risk factors, screening programmes resulting in earlier diagnosis but also the changing demographics of the population. More than a third of new cancer diagnoses and almost half of cancer survivors are now aged 70 years or older. Despite this increasing incidence, worldwide five-year cancer survival rates have improved significantly over the past two decades. After cancer, cardiovascular disease is the second most common cause of death in developed countries. With continued improvements in overall prognosis, patients with cancer have an increased exposure to cardiovascular risk factors resulting in higher cardiovascular morbidity and mortality, particularly in older patients. This relationship between cancer and cardiovascular disease is not surprising as they share the common risk factors of aging, smoking, obesity, and poor diet. In this review, we discuss the toxicity of cancer treatments on the cardiovascular system, particularly in older patients. We focus primarily on radiotherapy and anthracycline chemotherapy because of their chronic adverse effects and appraise approaches toward the detection and treatment of this toxicity to maximise survival and quality of life of older patients with cancer. 相似文献
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Late local recurrences in a randomised trial comparing conservative treatment with total mastectomy in early breast cancer patients. 总被引:4,自引:0,他引:4
R Arriagada M G Lê J-M Guinebretière A Dunant F Rochard T Tursz 《Annals of oncology》2003,14(11):1617-1622
BACKGROUND: A randomised trial was conducted comparing wide lumpectomy and breast irradiation with modified radical mastectomy. As the follow-up was long (mean duration 22 years), we analysed the variation in the effect of treatment over time. PATIENTS AND METHODS: The trial included 179 patients with a breast cancer measuring =2 cm at macroscopic examination. Eighty-eight patients had breast-conserving surgery and radiotherapy, and 91 underwent mastectomy. All patients had axillary dissection. The analyses were based on Cox models with time-dependent treatment effects. RESULTS: The effect of treatment on death or metastasis did not vary with time. The risk of local recurrence was lower during the first 5 years for the breast-conserving surgery group as compared with the mastectomy group, but higher after 5 years (P = 10(-4) for a different treatment effect over time). Similar results were found in a database including 1847 patients with small breast tumours at diagnosis. In this analysis, late breast recurrences were also more frequent in the breast-conserving surgery group and this treatment effect was greater among younger patients (=40 years at the time of diagnosis). CONCLUSIONS: Late breast recurrences were more frequently observed in younger patients treated with breast-conserving treatment compared with those submitted to mastectomy. These results require confirmation in other randomised studies so that younger patients with early breast cancer can receive adequate counselling and so that a more stringent long-term follow-up policy can be adopted when breast-conserving treatment is planned. 相似文献
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Yamamoto Y Iwase H 《International journal of clinical oncology / Japan Society of Clinical Oncology》2008,13(5):384-394
For the medical treatment of early breast cancer, aromatase inhibitors (AIs) such as anastrozole, letrozole, and exemestane
are more effective than selective estrogen-receptor modulators (SERMs) such as tamoxifen (TAM). However, the adverse events
associated with AIs are different from those associated with SERMs. Hot flushes, gynecological disorders, and thrombosis are
more frequent in patients treated with TAM than in those treated with AIs. Conversely, osteoporosis, fractures, joint symptoms,
and myalgia are more common in patients receiving AIs. Osteoporosis and bone fractures resulting from osteoporosis are important
issues for patients treated with AIs. The precise management of bone health, in strict accordance with clinical guidelines,
is vital in patients receiving AIs. AI-related joint symptoms are also one of the most important considerations for patients
taking AIs. AI-related joint symptoms are the most common reason for the discontinuation of AIs. Confirmed management strategies
for AI-related joint symptoms are unavailable at present. In patients receiving AIs, long-term adverse events (for example,
those occurring as a result of changing lipid metabolism) remain unclear. There is a clear need to elucidate AI-related adverse
events over the long term and to establish management strategies for AI-related adverse events, such that AIs can be used
safely in patients with breast cancer over long periods of time. 相似文献
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胰腺癌早期症状隐匿,恶性程度高,是消化系统常见的恶性肿瘤之一。外科手术是延长胰腺癌患者生存期的最佳选择,但只有15%~20%的胰腺癌患者能接受手术治疗。其余患者因局部晚期或全身转移,只能进行以内科治疗为主的综合治疗。目前晚期胰腺癌患者的首选治疗方式是以吉西他滨为基础的化疗,但仅使晚期胰腺癌患者的平均生存期延长为5.5~7个月,疗效有限。近几年,多项研究证实白蛋白结合型紫杉醇联合替吉奥治疗晚期胰腺癌可以提高患者的PFS和OS(分别为6.2个月和13.6个月)。治疗过程中最常出现的不良反应是中性粒细胞减少,但未出现因不良反应而停止治疗或死亡的现象。为晚期胰腺癌患者的治疗带来了新希望。本文将总结白蛋白结合型紫杉醇联合替吉奥在治疗晚期胰腺癌中的相关研究。 相似文献
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目的探讨甲磺酸阿帕替尼联合依托泊苷治疗晚期、复发、难治性三阴性乳腺癌的疗效及不良反应。方法收集10例晚期复发难治性三阴性乳腺癌患者的临床资料,均接受甲磺酸阿帕替尼联合依托泊苷治疗,观察用药后疾病控制率(DCR)、客观缓解率(ORR)、无进展生存期(PFS)并记录不良反应。结果10例患者均接受了至少2个周期的治疗,无完全缓解病例,部分缓解4例,疾病稳定5例,疾病进展1例,ORR为40%(4/10),DCR为90%(9/10),中位PFS为4.0个月(95%CI:1.15~6.85)。阿帕替尼联合依托泊苷作为二线治疗方案治疗晚期复发难治性三阴性乳腺癌患者的中位PFS为4.0个月,与作为二线以上治疗方案的3.0个月比较,差异无统计学意义(P﹥0.05)。阿帕替尼联合依托泊苷治疗2个部位转移三阴性乳腺癌患者的中位PFS为4.0个月,与治疗2个以上部位转移患者的7.0个月比较,差异无统计学意义(P﹥0.05)。10例三阴性乳腺癌患者最常见治疗相关不良反应为中性粒细胞减少,发生率为50.0%,不良反应以1~2级为主,仅发生1例3~4级不良反应,经对症治疗后好转,无治疗相关死亡。结论甲磺酸阿帕替尼联合口服依托泊苷化疗对晚期复发难治性三阴性乳腺癌有一定疗效,不良反应可控。 相似文献