Abstract

Purpose: Technological advancement in the treatment of cancer together with early detection and diagnosis have considerably improved the survival of breast cancer patients. On the other hand, the potential of patients developing side effects from cancer treatment are not negligible. Despite the progress that has been made in terms of early diagnosis, therapy, and survival, including improvements in the chemotherapeutic agents, radiation and molecular targeted therapies, cardiotoxicity of cancer therapy is still cause for concern. Radiation therapy for breast cancer is associated with increased risk of heart disease and myocardial infarction. Furthermore, the association of radiation therapy to chemotherapy is an important aspect to be considered in the development of cardiac disease, as this could play an additional role as a risk factor. Besides the heart effect, other side effects can be observed in the bone, ovary, uteri, and other organs. This paper aims to review the recent literature to present the current understanding of side effects associated with breast cancer treatment. The focus is on recent preclinical studies that have assessed potential changes in different organs that may be injured after breast cancer treatment, both due to both radiation and chemotherapy agents.

Conclusion: Radiation-induced heart disease is one important side effect that must be considered during the treatment planning and patient follow-up. The cardiac damage can be potentialized when chemotherapy is associated to radiotherapy, and the literature findings indicate that heart fibrosis plays an important role at the radio-chemotherapy induced cardiac damage. Literature findings also showed important side effects at the bone, that can lead to ospeoporosis, due to the decrease of calcium, after radio or chemotherapy treatments. This decrease could be explained by the ovarian failure observed at rats after chemotherapy treatment. It is of great importance to acknowledge the complications originating from the treatment, so that new strategies can be developed. In this way, it will be possible to minimize side effects and improve the patients’ quality of life.

摘要

目的：癌症治疗的技术进步以及早期检测和诊断大大提高了乳腺癌患者的生存率。另一方面，患者因癌症治疗而产生副作用的可能性不容忽视。尽管在早期诊断、治疗和生存方面取得了进展，包括化疗药物、放射和分子靶向治疗的改进，但癌症治疗的心脏毒性仍然令人担忧。乳腺癌的放射治疗与心脏病和心肌梗塞的风险增加有关。此外，放疗与化疗的关联是心脏疾病发展中需要考虑的一个重要方面，因为这可能作为一个危险因素发挥额外的作用。除了心脏效应外，还可以在骨骼、卵巢、子宫和其他器官中观察到其他副作用。本文旨在回顾最近的文献，以介绍当前对与乳腺癌治疗相关的副作用的理解。重点是最近的临床前研究，这些研究评估了乳腺癌治疗后可能因放疗和化疗药物而受伤的不同器官的潜在变化。

结论：辐射诱发的心脏病是治疗计划和患者随访期间必须考虑的一种重要副作用。放化疗联合放疗可能引起心脏损伤，文献研究表明心脏纤维化在放化疗引起的心脏损伤中起重要作用。文献研究结果还表明，在放疗或化疗后，由于钙的减少，骨骼有重要的副作用，可导致骨质疏松症。这种减少可以用化疗治疗后在大鼠身上观察到的卵巢功能衰竭来解释。认识到治疗引起的并发症非常重要，这样才能制定新的策略。通过这种方式，