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乳腺癌治疗中的心脏毒性:风险、机制及预防策略。

Cardiotoxicity in Breast Cancer Therapy: Risks, Mechanisms, and Prevention Strategies.

作者信息

Fitrianti Annisa Eka, Wardani Nadea Olyvia, Astuti Astri, Anggadiredja Kusnandar, Amalia Lia, Putri Risani Andalasia, Zazuli Zulfan

机构信息

Master's Program in Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia.

Department of Pharmacy, Dr. Hasan Sadikin General Hospital, Bandung 40161, Indonesia.

出版信息

Med Sci (Basel). 2025 Aug 14;13(3):130. doi: 10.3390/medsci13030130.

Abstract

Breast cancer is the most prevalent cancer in women. Anthracyclines are commonly used as the first line of treatment, often combined with other agents, including trastuzumab. Despite their efficacy, both drugs pose a risk of cardiotoxicity, which may impair patients' quality of life (QoL) and hinder treatment persistence. Anthracycline-induced cardiotoxicity is dose-dependent and generally irreversible, whereas trastuzumab is associated with potentially reversible cardiac dysfunction. This review discusses the risk factors and biological mechanisms underlying chemotherapy-induced cardiotoxicity in breast cancer and explores effective strategies for prevention and treatment. It has been demonstrated that several cardioprotective strategies, such as treatments with angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), beta-blockers, and dexrazoxane, can help lessen cardiotoxic effects. A better understanding of cardioprotective strategies may help optimize cancer treatment without compromising cardiovascular function.

摘要

乳腺癌是女性中最常见的癌症。蒽环类药物通常用作一线治疗药物,常与包括曲妥珠单抗在内的其他药物联合使用。尽管它们疗效显著,但这两种药物都有心脏毒性风险,这可能会损害患者的生活质量(QoL)并阻碍治疗的持续性。蒽环类药物引起的心脏毒性具有剂量依赖性且通常不可逆,而曲妥珠单抗与潜在可逆的心脏功能障碍有关。本综述讨论了乳腺癌化疗诱导心脏毒性的危险因素和生物学机制,并探索了有效的预防和治疗策略。已经证明,几种心脏保护策略,如使用血管紧张素转换酶抑制剂(ACEIs)、血管紧张素受体阻滞剂(ARBs)、β受体阻滞剂和右丙亚胺进行治疗,可以帮助减轻心脏毒性作用。更好地理解心脏保护策略可能有助于在不损害心血管功能的情况下优化癌症治疗。

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