儿童癌症幸存者中膜病变的危险因素
Rivalin Aho Glele1,2,3, Elizabeth A M Feijen4, Brice Fresneau1,2,3,5
1Radiation Epidemiology Group, INSERM, Unit 1018-CESP, Villejuif, France.
JAMA oncology
|October 9, 2025
概括
儿童癌症幸存者面临心脏膜心脏病 (VHD) 风险增加的心脏辐射疗法 (RT) 和人类循环药,风险随着时间的推移而升级. 对这些幸存者来说,长期的心脏监测至关重要.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 儿童癌症的存活率有所改善,导致人们更加关注长期不良影响,如膜心脏病 (VHD).
- 确定VHD的特定治疗相关风险因素对于改善儿童癌症幸存者的长期健康结果至关重要.
研究的目的:
- 确定长期儿童癌症幸存者的大型欧洲队列中膜心脏病 (VHD) 的与治疗相关的风险因素.
- 分析放射治疗 (RT) 和化疗暴露以及症状性VHD的发展之间的关联.
主要方法:
- 一个嵌套的病例控制研究,利用来自PanCareSurFup和ProCardio队伍的数据.
- 涉及到详细的辐射剂量重建和评估1940年至2009年期间诊断的儿童癌症幸存者的累积细胞毒剂暴露.
- 根据亚队列,性别,诊断时的年龄和诊断年龄,匹配了225例有症状的VHD与1:2的对照.
主要成果:
- 心脏放射治疗 (RT) 与VHD风险密切相关,显示出指数级的剂量反应关系.
- 累积剂量的人环素 (≥400 mg/m2) 和剂也与增加VHD风险有关.
- 与RT和人类循环药物相关的VHD风险随着随访时间和患者年龄的延长而显著增加.
结论:
- 心脏RT,人环素和剂是儿童癌症幸存者中VHD的重要危险因素.
- 随着时间的推移,RT和人类循环药物增加的VHD风险凸显了这一群体持续,长期心脏监测的关键需求.
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