Vpliv visokodozne in nizkodozne izpostavljenosti srčnih struktur na srčno-žilne posledice obsevanja raka dojke in raka pljuč

Ivica Ratoša (Author), Jasna But Hadžić (Author)

Abstract

Izhodišča: Z daljšanjem preživetja bolnikov z rakom so srčno- -žilne bolezni postale pomemben del morbiditete in mortalitete teh bolnikov. V zadnjih letih je v literaturi veliko zanimanja na področju vpliva radioterapije na pozne posledice na srcu. Metode: Literaturo smo poiskali s pomočjo spletnega iskalnika PubMed / MEDLINE z uporabo kombinacij ustreznih ključnih besed. V postopku ocenjevanja smo preučili grobe rezultate iskanja in izključili članke, ki niso pomembni za to temo. Upoštevali smo le literaturo v angleškem jeziku. Rezultati: Objavljene so različne doznovolumske omejitve na srce v povezavi s srčno-žilnimi obolenji in smrtnostjo, vendar te omejitve niso enotno veljavne. Pri dopolnilnem obsevanju raka dojk je celotno srce izpostavljeno nizki dozi in se pomembne srčne okvare najpogosteje izrazijo desetletje po zdravljenju ali še pozneje, pri visokodozni izpostavljenosti pri radikalnem obsevanju pljuč pa se smrtnost zaradi srčno-žilnih dogodkov poveča že v prvih letih po zdravljenju. Zaključek: Z nižanjem doze na srce lahko še dodatno vplivamo na preživetje bolnikov po obsevanju, kar nam že omogočajo boljše obsevalne tehnike in slikovno vodena radioterapija. Dodatno korist lahko dosežemo še z boljšim razumevanjem in upoštevanjem vpliva obsevanja na posamezne srčne strukture, tudi v povezavi z pridruženimi boleznimi, in z usmerjenim kardiološkim spremljanjem bolnikov po obsevanju prsnega koša.

Keywords

obsevanje;rak dojk;rak pljuč;

Data

Language:	Slovenian
Year of publishing:	2021
Typology:	1.02 - Review Article
Organization:	OI - Institute of Oncology
UDC:	616-006
COBISS:	66138883
ISSN:	1408-1741
Views:	555
Downloads:	172
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	ǂThe ǂimpact of high and low cardiac substructure dose levels on cardiac toxicity in lung and breast cancer radiotherapy
Secondary abstract:	Background: With improved survival outcomes for patients with cancer, cardiovascular disease has become an important part of morbidity and mortality. In recent years, there has been much interest in the literature on the impact of radiotherapy on late cardiac toxicity. Methods: Published manuscripts were identified through a PubMed/MEDLINE search of the National Library of Medicine using combinations of relevant keywords. In the evaluation round, we examined rough search results and excluded articles not relevant for the topic. We considered only English language literature. Results: Various cardiac dose-volume constraints have been reported in association with cardiovascular events and mortality, but without consistent constraints. Low-dose heart exposure in adjuvant breast cancer radiotherapy can lead to important cardiac events a decade or more after treatment. However, in radical lung cancer radiotherapy, high-dose heart exposure can lead to increased cardiovascular mortality in the first few years after treatment. Conclusion: We can further influence the survival of patients with cancer after chest irradiation by lowering the absorbed dose to the heart, which is already made possible by better irradiation techniques and image-guided radiotherapy. Additional benefits can be gained by better understanding and considering the impact of radiation on individual cardiac structures, also in connection with other patients’ comorbidities, and by the close cardiac follow-up of patients after chest radiation therapy.
Secondary keywords:	radiotherapy;breast cancer;lung cancer;
Pages:	str. 32-40
Volume:	ǂLeto ǂ25
Issue:	ǂšt. ǂ1
Chronology:	2021
ID:	13011181