Evidence-based Studies On The Risk Factors And Prevention Of Radiation-induced Heart Disease

Objective Radiation-induced Heart Disease(RIHD)is one of the most serious adverse reactions after long-term radiation therapy for thoracic malignant tumors.Although radiation therapy can improve the overall survival of cancer patients.The presence of RIHD affects the quality of life of cancer patients and may even reduce their survival expectations.In this study,we searched the relevant Chinese and English studies on RIHD,and analyzed the current research status and research topics of RIHD studies,and analyze the risk factors and drug efficacy of RIHD by meta-analysis method,which could support the evidence for the related researcher.Methods The RIHD studies were searched in the main Chinese and English databases from the establishment of the database to November 31,2018.Firstly,the bibliometrics method was used to analysis the published time,authors,organization,keywords and other information of RIHD by BICOMS-2,Ucinet 6.0,Net Draw and g Cluto1.0 software.Secondly,the method of Meta-analysis,and Rev Man 5.3software was used to quantitatively analyze the risk factors and drug efficacy of RIHD.Results A total of 1523 RIHD papers(237 Chinese papers,427 English papers)were collected.Bibliometric results show that the first Chinese RIHD study was published in 1982,but the first English study was published in 1967,and 15 years earlier than the Chinese study.The number of Chinese and English studies of RIHD has increased year by year,Chinese RIHD studies were an imbalance in distributions of provinces,as for the English RIHD studies,the number of studies of RIHD in developing countries was less than that in developed countries,the cooperation between Chinese RIHD studies were relatively distant,and the cooperation between English RIHD studies were closer,The Chinese RIHD studies could divided into three research topics,and the English RIHD studies could divided into four topics.Meta-analysis of RIHD risk factors showed that compared with other chest tumors,radiotherapy dose <55Gy and conventional field radiation,the left thoracic tumors[OR=3.93,95% CI(2.78,5.56),P<0.00001],radiotherapy dose ?55 Gy [OR=4.34,95%CI(3.27,5.76),P<0.00001] and large area irregular field conventional irradiation[OR=2.57,95%CI(1.17,5.65),P=0.02].The results of RIHD Meta-analysis showed that,based on clinical researches,the 1,6-diphosphate fructose,Shenmai injection,Shenqi Fuzheng injection,Shensong Yangxin capsule,Salidrosid,Shensong Yangxin capsule combined Salidrosid,Danhong injection,Huang Qi injection,sodium creatine injection,Shengmai injection,Zixinyin capsule combined Hedyotis diffusa injection and L-carnitine injection,among the 12 interventions,besides the Shensong Yangxin capsule,Salidrosid,Shensong Yangxin capsule combined Salidrosid,all other interventions have certain preventive effects on RIHD.Based on animal experiments,curcumin,pioglitazone,atorvastatin,losartan,trimetazidine,pentoxifylline combined tocopherol and salidroside have certain preventive effects on RIHD.Conclusion The number of Chinese and English RIHD studies has increased year by year,and the regional distribution was imbalanced.The research topic is relatively concentrated.The location of tumor,radiotherapy dose,irradiation fields were the risk factors of RIHD.There was no specificity intervention for the RIHD.In the future,the researcher should adopt the reai-world study to assess the efficacy of Chinese medicines.