整体纵向应变评估乳腺癌放疗所致心脏毒性的价值：系统综述和meta分析

徐晓飞; 张丽霞; 代贺阳; 陈凌云; 薛姣姣; 李庆霞

doi:10.19401/j.cnki.1007-3639.2022.10.005

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整体纵向应变评估乳腺癌放疗所致心脏毒性的价值：系统综述和meta分析

论著 | 更新时间：2025-12-31

- 整体纵向应变评估乳腺癌放疗所致心脏毒性的价值：系统综述和meta分析
- Value of global longitudinal strain in assessing radiation-induced heart disease in breast cancer: systematic review and meta-analysis
- 中国癌症杂志 2022年32卷第10期页码：971-978
- 作者机构：
  
  1. 河北医科大学研究生院，河北石家庄 050017
  2. 河北省人民医院肿瘤四科，河北石家庄 050051
  3. 华北理工大学研究生学院，河北唐山 063210
- 作者简介：
  
  [ "徐晓飞（ORCID: 0000-0003-0236-2497），E-mail: xuxiaofei2543@163.com。" ]
- 基金信息：
  
  河北省科技厅国际科技合作基地建设专项《乳腺癌特异性多靶点诊疗方案联合研发合作示范》(19392411D)
- DOI：10.19401/j.cnki.1007-3639.2022.10.005
  中图分类号： R737.9
- 收稿：2022-06-23，
  
  修回：2022-10-13，
  
  网络出版：2022-10-30，
- 稿件说明：
移动端阅览
徐晓飞, 张丽霞, 代贺阳, 等. 整体纵向应变评估乳腺癌放疗所致心脏毒性的价值：系统综述和meta分析[J]. 中国癌症杂志, 2022,32(10):971-978.

Xiaofei XU, Lixia ZHANG, Heyang DAI, et al. Value of global longitudinal strain in assessing radiation-induced heart disease in breast cancer: systematic review and meta-analysis[J]. China Oncology, 2022, 32(10): 971-978.
徐晓飞, 张丽霞, 代贺阳, 等. 整体纵向应变评估乳腺癌放疗所致心脏毒性的价值：系统综述和meta分析[J]. 中国癌症杂志, 2022,32(10):971-978. DOI： 10.19401/j.cnki.1007-3639.2022.10.005.

Xiaofei XU, Lixia ZHANG, Heyang DAI, et al. Value of global longitudinal strain in assessing radiation-induced heart disease in breast cancer: systematic review and meta-analysis[J]. China Oncology, 2022, 32(10): 971-978. DOI： 10.19401/j.cnki.1007-3639.2022.10.005.

摘要

背景与目的：

乳腺癌已超过肺癌成为全球最常见的恶性肿瘤。早期乳腺癌患者经过综合治疗可以获得较长的生存期，但放疗引起的心脏毒性可能会影响远期预后。因此，早期监测放疗相关心脏损伤对于改善乳腺癌患者生存期具有重要意义。斑点追踪超声心电图（speckle-tracking echocardiography，STE）是一项研究心肌变形的新技术，其中整体纵向应变（global longitudinal strain，GLS）是评估放疗所致早期心脏损伤的良好参数。本文旨在探讨GLS评估乳腺癌放疗所致心脏毒性的价值。

方法：

计算机检索PubMed、EMBASE、Web of Science、Cochrane Library、万方及中国知网即中国知识基础设施工程（China National Knowledge Infrastructure，CNKI）数据库，检索时间为2010年1月—2022年3月，按照预先设定的纳入排除标准，筛选利用GLS、整体纵向应变率（global longitudinal strain rate，GLSr）及左心室射血分数（left ventricular ejection fraction，LVEF）评估乳腺癌放疗过程中及放疗后心肌功能变化。由2名研究者独立进行文献筛选、资料提取。采用Review Manager 5.4分析软件进行数据分析。

结果：

最终纳入9项研究，共涉及543例患者，meta分析结果显示，左侧乳腺癌患者LEVF在放疗后即刻轻微下降，WMD为-0.98，在放疗后6个月有所上升，WMD为-0.83，但仍低于基线水平。右侧乳腺癌放疗后LVEF几乎没有变化。左侧乳腺癌患者放疗后即刻、放疗后6周、6个月、12个月GLS显著下降，WMD分别为1.57、1.84、1.04、1.69，差异有统计学意义，各研究之间无显著异质性。而右侧乳腺癌放疗后GLS无显著变化。不同侧乳腺癌GLSr的变化相差不大。

结论：

GLS可能是左侧乳腺癌患者放射治疗所致心脏损伤的较好预测指标。

Abstract

Background and purpose:

Breast cancer has overtaken lung cancer as the most common malignant tumor in women. Early breast cancer patient can achieve a long survival time after comprehensive treatment

however the cardiotoxicity caused by radiotherapy may affect its long-term progn

osis. Therefore

early monitoring of radiation-induced heart disease is important for improving the survival of breast cancer patients. Speckle-tracking echocardiography (STE) is a new technique to study myocardial deformation. Global longitudinal strain (GLS) is a good parameter for evaluating early cardiotoxicity caused by radiotherapy. The purpose of this study was to evaluate the value of GLS in evaluating radiotherapy-induced early cardiotoxicity in breast cancer.

Methods:

PubMed

EMBASE

Web of Science

Cochrane Library

Wanfang and China National Knowledge Infrastructure (CNKI) databases were searched by computer from January 2010 to March 2022. According to the pre-set inclusion and exclusion criteria

screening studies was performed using GLS and left ventricular ejection fraction (LVEF) to evaluate myocardial function changes during and after radiotherapy for breast cancer. Two researchers independently conducted literature screening and data extraction. Review Manager5.4 analysis software was used for data analysis.

Results:

Finally

9 studies were included

involving a total of 543 patients. Meta-analysis results showed that LVEF of patients with left breast cancer decreased slightly immediately after radiotherapy

and WMD was -0.98. LVEF of those patients increased at 6 months after radiotherapy

and the WMD was -0.83

which was still lower than baseline. LVEF was almost unchangeable after radiotherapy for right breast cancer. GLS of left-sided breast cancer patients decreased significantly immediately after radiotherapy

at 6 weeks

6 months and 12 months after radiotherapy

and WMD was 1.57

1.84

1.04 and 1.69

respectively. The differences were statistically significant. There was no significant heterogeneity among the studies. However

there was no significant change in GLS after radiotherapy for right breast cancer. There was no significant difference in GLSr between breast cancers of different sides.

Conclusion:

GLS may be a good predictor of radiation-in

duced heart disease in patients with left-sided breast cancer.

关键词

Keywords

references

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