当前位置: X-MOL 学术J. Clin. Oncol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Increased Risk of Cardiovascular Sequelae in Survivors of Male Germ Cell Cancer.
Journal of Clinical Oncology ( IF 42.1 ) Pub Date : 2020-03-18 , DOI: 10.1200/jco.20.00163
Suparna C Clasen 1 , Chunkit Fung 1 , Paul C Dinh 1 , Lois B Travis 1
Affiliation  

Studies in the United States1 and Europe2-6 have shown that both early and late cardiovascular effects are associated with platinum-based therapies. In their recent publication, Lauritsen et al2 undertake an epidemiologic survey to assess early and long-term cardiovascular effects in male survivors of germ cell cancer (GCC) compared with age-matched controls using data from the Danish National Registry (median follow-up, 15.8 years). Those treated with bleomycin, etoposide, and cisplatin (BEP) had a marked six-fold increased risk of myocardial infarction in the first year after therapy.2 Their study adds further evidence that there is an increased risk of cardiovascular disease (CVD) within the first year after platinum-based chemotherapy. These findings are similar to those of Fung et al1 who used data from the population-based Surveillance, Epidemiology, and End Results (SEER) Program, which addressed CVD mortality in patients with GCC. As in Fung et al,1 results in Lauritsen et al2 were based on relatively few incident cases of myocardial infarction (7 of 1,360 patients). This leaves us with two practical clinical questions: What are the mechanisms of action? How do we risk-stratify these patients in the acute period after treatment? One postulated mechanism has been that the increased risk of CVD may be due to direct vascular injury, endothelial dysfunction, and a hypercoagulable state in the first year after treatment with BEP.1,2,7 Although the relatively low number of cases of CVD might be reassuring, the high morbidity and mortality of a major cardiovascular and/or cerebrovascular event while undergoing treatment for GCC can be potentially devastating. Evidence-based practices need to be developed to better risk-stratify those at high risk during their first year after chemotherapy.

中文翻译:

男性生殖细胞癌幸存者心血管后遗症的风险增加。

美国1和欧洲2-6的研究表明,早期和晚期心血管效应均与铂类疗法有关。Lauritsen等人[ 2]在最近的出版物中进行了一项流行病学调查,以评估丹麦生殖细胞癌(GCC)男性幸存者与年龄匹配的对照组相比早期和长期的心血管影响,并使用丹麦国家注册局的数据(中位随访) ,15.8年)。治疗后第一年,用博来霉素,依托泊苷和顺铂(BEP)治疗的患者发生心肌梗塞的风险明显增加了六倍。2他们的研究进一步证明了铂类化疗后第一年内发生心血管疾病(CVD)的风险增加。这些发现与Fung等[ 1]的研究相似,他们使用了基于人群的监测,流行病学和最终结果(SEER)计划的数据,该计划解决了GCC患者的CVD死亡率。与Fung等人一样,Lauritsen等人1的结果2基于相对较少的心肌梗死事件案例(1,360名患者中的7名)。这给我们留下了两个实际的临床问题:作用机理是什么?在治疗后的急性期我们如何对这些患者进行风险分层?一种推测的机制是,CVD风险增加可能是由于直接血管损伤,内皮功能障碍和BEP治疗后第一年的高凝状态所致。1,2,7尽管相对较少的CVD病例可以使人放心,但是在接受GCC治疗时发生重大心血管和/或脑血管事件的高发病率和高死亡率可能具有破坏性。需要发展循证实践,以更好地对高危人群在化疗后的第一年进行风险分层。
更新日期:2020-03-18
down
wechat
bug