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儿童癌症存活率中的心脏毒性:回顾性队列研究
Masab Mansoor1, Andrew Ibrahim2
1Edward Via College of Osteopathic Medicine, 4408 Bon Aire Drive, Monroe, LA, 71203, United States, 1 504-521-3500.
JMIRx med
|July 31, 2025
概括
儿童癌症幸存者在30年内患上心血管并发症的风险为18.7%. 关键的危险因素包括抗环素化疗和胸部辐射,需要终身监测.
科学领域:
- 儿科瘤学 儿科瘤学
- 心血管医学 心血管医学
- 流行病学 流行病学
背景情况:
- 改善的儿科癌症生存率突出显示了长期治疗效果.
- 心血管并发症是幸存者患病和死亡的主要原因.
- 了解心脏毒性对于风险分层和护理规划至关重要.
研究的目的:
- 调查儿童癌症幸存者心脏毒性的流行,发病率和危险因素.
- 确定特定的心血管并发症及其相关预测因素.
- 开发心脏毒性风险预测模型.
主要方法:
- 对24938名5年儿童癌症幸存者的回顾性队列研究 (1970-1999年).
- 通过问卷和医疗记录评估心血管并发症.
- 考克斯比例危险模型和多变量后勤回归用于风险因素分析和模型开发.
主要成果:
- 诊断后30年内心血管并发症的累积发病率为18.7%.
- 显著的危险因素:人环素暴露 (HR 2.31),胸部辐射 (HR 1.84),年龄较大,男性性别,肥胖.
- 风险预测模型显示出良好的歧视 (C-统计值0.78). 幸存者比兄弟姐妹的风险高3.7倍.
结论:
- 儿童癌症幸存者面临着严重的,持续的心血管并发症风险.
- 鉴定的风险因素和预测模型有助于个性化后续和干预.
- 对这一群体来说,终身心血管监测至关重要.
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