Cancer and cardiovascular (CV) disease are the most prevalent diseases in the developed world. Evidence increasingly shows that these conditions are interlinked through common risk factors, coincident in an ageing population, and are connected biologically through some deleterious effects of anticancer treatment on CV health. Anticancer therapies can cause a wide spectrum of short- and long-term cardiotoxic effects. An explosion of novel cancer therapies has revolutionised this field and dramatically altered cancer prognosis. Nevertheless, these new therapies have introduced unexpected CV complications beyond heart failure. Common CV toxicities related to cancer therapy are defined, along with suggested strategies for prevention, detection and treatment. This ESMO consensus article proposes to define CV toxicities related to cancer or its therapies and provide guidance regarding prevention, screening, monitoring and treatment of CV toxicity. The majority of anticancer therapies are associated with some CV toxicity, ranging from asymptomatic and transient to more clinically significant and long-lasting cardiac events. It is critical however, that concerns about potential CV damage resulting from anticancer therapies should be weighed against the potential benefits of cancer therapy, including benefits in overall survival. CV disease in patients with cancer is complex and treatment needs to be individualised. The scope of cardio-oncology is wide and includes prevention, detection, monitoring and treatment of CV toxicity related to cancer therapy, and also ensuring the safe development of future novel cancer treatments that minimise the impact on CV health. It is anticipated that the management strategies discussed herein will be suitable for the majority of patients. Nonetheless, the clinical judgment of physicians remains extremely important; hence, when using these best clinical practices to inform treatment options and decisions, practitioners should also consider the individual circumstances of their patients on a case-by-case basis.

中文翻译：

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在整个肿瘤治疗过程中癌症患者心脏病的管理：ESMO 共识建议。


癌症和心血管（CV）疾病是发达国家最普遍的疾病。越来越多的证据表明，这些疾病通过常见的危险因素相互关联，在人口老龄化中同时存在，并且通过抗癌治疗对心血管健康的一些有害影响在生物学上相互关联。抗癌疗法可引起广泛的短期和长期心脏毒性作用。新型癌症疗法的激增彻底改变了这一领域，并极大地改变了癌症预后。然而，这些新疗法带来了心力衰竭以外的意想不到的心血管并发症。定义了与癌症治疗相关的常见心血管毒性，并提出了预防、检测和治疗的建议策略。这篇 ESMO 共识文章建议定义与癌症或其治疗相关的 CV 毒性，并提供有关 CV 毒性的预防、筛查、监测和治疗的指导。大多数抗癌疗法都与一些心血管毒性有关，从无症状和短暂性到更具临床意义和持久的心脏事件。然而，至关重要的是，应权衡抗癌治疗可能造成的心血管损伤与癌症治疗的潜在益处（包括总体生存率的益处）。癌症患者的心血管疾病很复杂，治疗需要个体化。心脏肿瘤学的范围很广，包括与癌症治疗相关的心血管毒性的预防、检测、监测和治疗，并确保未来新型癌症治疗的安全开发，最大限度地减少对心血管健康的影响。预计本文讨论的管理策略将适合大多数患者。 尽管如此，医生的临床判断仍然极其重要。因此，当使用这些最佳临床实践来指导治疗选择和决策时，从业者还应该根据具体情况考虑患者的个人情况。