乳腺癌放射治疗致心脏损伤的保护及治疗研究进展

Advances in protection and treatment of cardiac injury during breast cancer radiotherapy

关键词:  乳腺癌  放射治疗  心脏损伤

Key words:  breast cancer  radiotherapy  radiation-induced heart disease

摘要:

乳腺癌是中国女性最常见的癌症，约有27%的乳腺癌患者接受放射治疗，这一比率随着保乳术的增加而呈上升趋势。然而放疗在降低乳腺癌患者的局部复发率的同时，可能会引起心脏的放射损伤，这种损伤一旦出现往往是不可逆的，放射性心脏病(radiation-induced heart disease, RIHD)已成为长期生存患者的主要非乳腺癌死亡原因。随着放疗技术的革新，心脏的受照剂量与体积被一再降低，从剂量学方面预防了RIHD的发生。本文就RIHD的损伤机制、精准放疗对心脏的保护措施、RIHD的影响因素与诊断以及RIHD治疗等方面的研究进展进行探讨。

Abstract:

Breast cancer is the most common type of cancer in Chinese women. About 27% of breast cancer patients receive radiation therapy. This rate is growing with the increasing number of breast-conserving surgery. However, although radiation therapy may reduce the local recurrence rate in breast cancer patients, it may cause cardiac radiation damage and such damage is often irreversible once it appears. Radiation-Induced Heart Disease (RIHD) has become the leading cause of non-breast cancer death in long-term survivors. With the innovation of radiotherapy technology, the radiation dosage and volume to the heart have been repeatedly reduced, and the occurrence of RIHD has been prevented from dosimetry. In this paper, the research progress of RIHD damage mechanism, cardiac protection measures when doing precise radiotherapy, influential factors and diagnosis of RIHD and RIHD treatment are discussed.