Background/Introduction: Colorectal carcinoma (CRC) belongs to the most commonly diagnosed malignancies to this date, ranking as third across the globe. In addition, CRC remains a leading cause of cancer-related deaths as it is ranked as the second most common cause of mortality. Therapeutic strategies for the management and treatment of CRC have made significant progress in the last two decades, with both adjuvant and neoadjuvant approaches playing critical roles in enhancing favorable outcomes with regimens like FOLFOX, CAPOX, and 5-FU-based therapies demonstrating effectiveness. Nevertheless, growing evidence indicates that these therapies may pose a risk of cardiotoxicity development. A systematic review will be conducted to map the mechanistic pathways of chemotherapy-induced in CRC in order to bridge oncology and cardiology perspectives, highlighting emerging diagnostic tools and long-term surveillance gaps.Purpose: The objective of this study is the investigation of the prevalence and characteristics of cardiovascular problems linked to frequently employed chemotherapy regimens, as well as to evaluate existing diagnostic and therapeutic approaches.Methodology: A thorough search across databases, including PubMed (MEDLINE), Embase, and Cochrane Library, was performed to locate articles published up to 2025. The final studies included in the review underwent quality assessment.Results: Fourteen qualifying studies, comprising both prospective trials and case reports from diverse geographies, were included. Cardiovascular outcomes including myocardial strain, arrhythmias, angina, heart failure, and Takotsubo cardiomyopathy were evaluated. The diagnostic methods assessed comprised echocardiography, cardiac biomarkers, and electrocardiograms. In the reviewed trials, chemotherapy-induced cardiotoxicity varied from asymptomatic ventricular strain to serious cardiac complications. The FOLFOX and 5-FU regimens were predominantly linked to adverse cardiac outcomes. Prompt identification by echocardiographic strain imaging and biomarker monitoring facilitated timely intervention. Case studies revealed that, given proper cardiological support, certain patients could safely recommence chemotherapy following recovery. No standardized cardiac screening protocol was identified among the trials.Conclusions: Chemotherapy for colorectal cancer may present considerable cardiovascular hazards, highlighting the necessity for routine cardiac monitoring prior to and throughout treatment. This systematic review promotes collaborative cardio-oncology strategies to reduce risk and enhance therapeutic safety.
背景/引言：结直肠癌是目前最常见的恶性肿瘤之一，全球发病率位列第三。同时，该疾病作为癌症相关死亡的第二大原因，仍是导致患者死亡的主要因素。过去二十年间，结直肠癌的治疗策略取得显著进展，辅助治疗与新辅助治疗方案在改善预后方面发挥关键作用，其中FOLFOX、CAPOX及基于5-FU的疗法均显示出明确疗效。然而，越来越多的证据表明这些治疗方案可能诱发心脏毒性风险。本研究将通过系统综述梳理结直肠癌化疗所致心脏毒性的作用机制通路，以搭建肿瘤学与心脏病学之间的桥梁，并着重探讨新兴诊断工具及长期监测领域的空白。 目的：本研究旨在探究常用化疗方案相关心血管问题的发生率与临床特征，并对现有诊断与治疗方法进行评估。 方法：通过系统检索PubMed（MEDLINE）、Embase及Cochrane Library等数据库，纳入截至2025年发表的相关文献。最终纳入综述的研究均经过质量评估。 结果：共纳入14项符合标准的研究，涵盖多地区的前瞻性试验与病例报告。研究评估的心血管结局包括心肌应变异常、心律失常、心绞痛、心力衰竭及Takotsubo心肌病。评估的诊断方法涵盖超声心动图、心脏生物标志物及心电图。综合分析显示，化疗所致心脏毒性表现可从无症状心室应变至严重心脏并发症不等，其中FOLFOX与5-FU方案与不良心脏结局关联最为显著。通过超声心动图应变成像与生物标志物监测可实现早期识别并及时干预。病例研究表明，在适当心脏支持治疗下，部分患者康复后可安全重启化疗。现有试验中尚未建立标准化的心脏筛查方案。 结论：结直肠癌化疗可能带来显著心血管风险，强调治疗前及治疗期间常规心脏监测的必要性。本系统综述倡导建立心脏肿瘤协作诊疗策略，以降低治疗风险并提升治疗安全性。
肿瘤(癌症)患者之家