Background: This meta-analysis and systematic review aim to consolidate evidence on cardiotoxicity prevention and treatment strategies in patients receiving anthracyclines or HER2 receptor inhibitors, vital treatments for breast cancer and hematologic malignancies. By synthesizing existing research, the goal is to provide impactful insights that enhance patient care and outcomes. Methods: Comprehensive research across PubMed, Scopus, EMBASE, and the Cochrane Central Register for Controlled Trials was conducted, selecting clinical trials focusing on cardioprotection in anthracyclines or HER2 inhibitor-treated individuals. Effect sizes were computed using OpenMeta (Analyst), with leave-out meta-analysis to assess potential small study effects. Meta-regression explored treatment duration and sample size effects. Evidence quality for primary outcomes was evaluated using ROB, Robins 2, and Newcastle-Ottawa tools. Results: Twenty -three studies involving a total of 14,652 patients (13,221 adults and 1431 kids) were included in the current systematic review and meta-analysis. The risk of bias and methodological quality of the included studies suggested good and moderate quality. Patients prescribed β-blockers demonstrated a 74% lower likelihood of exhibiting cardiotoxicity symptoms (OR 1.736). Similarly, the use of dexrazoxane was linked to a threefold decrease in cardiac abnormalities risk (OR 2.989), and ACE inhibitor administration showed half the risk compared with the control group (OR 1.956). Conclusions: Through this systematic review and meta-analysis, it was shown that there is a reduction in cardiotoxicity from either anthracyclines or HER2 inhibitors in patients receiving pharmacoprophylaxis.
背景：本荟萃分析与系统综述旨在整合关于接受蒽环类药物或HER2受体抑制剂（乳腺癌及血液系统恶性肿瘤的关键治疗药物）患者心脏毒性预防与治疗策略的证据。通过综合现有研究，旨在提供具有影响力的见解，以优化患者护理并改善临床结局。 方法：系统检索了PubMed、Scopus、EMBASE及Cochrane对照试验中心注册库，筛选出聚焦蒽环类药物或HER2抑制剂治疗患者心脏保护的临床试验。使用OpenMeta（Analyst）计算效应量，采用留一法荟萃分析评估潜在的小样本效应。通过荟萃回归分析探讨治疗时长与样本量的影响。使用ROB、Robins 2和纽卡斯尔-渥太华量表工具评估主要结局的证据质量。 结果：本次系统综述与荟萃分析共纳入23项研究，总计14,652例患者（成人13,221例，儿童1,431例）。纳入研究的偏倚风险与方法学质量评估显示其质量良好至中等。使用β受体阻滞剂的患者出现心脏毒性症状的可能性降低74%（OR 1.736）。类似地，右雷佐生的使用与心脏异常风险降低三倍相关（OR 2.989），而血管紧张素转换酶抑制剂治疗组风险较对照组降低一半（OR 1.956）。 结论：本系统综述与荟萃分析表明，接受药物预防的患者中，蒽环类药物或HER2抑制剂所致心脏毒性显著降低。
肿瘤(癌症)患者之家