儿童癌症幸存者人数迅速增加。根据美国癌症研究协会的报道，美国和欧洲的儿童癌症幸存者人数已经超过75万人。随着儿童癌症幸存者人数的增加，癌症治疗相关的心脏功能障碍（CTRCD）和心力衰竭（HF）发生率也在增加。有报道称，接受蒽环类药物治疗的儿童癌症幸存者出现晚期癌症治疗相关的HF的可能性是普通人群的15倍，并且出现心血管疾病致死的风险是普通人群的5倍。心血管疾病是儿童癌症幸存者的主要死因。对癌症幸存者患者进行管理的需求增加，促使了心脏肿瘤学的快速发展和适应。心脏肿瘤学是一门多学科的科学，用于监测、治疗和预防CTRCD。已经发表了许多指南和立场文件来帮助诊断和管理CTRCD，包括来自美国临床肿瘤学会、欧洲心脏病学会、加拿大心血管学会、欧洲医学肿瘤学会、儿童癌症晚期影响国际指南协调小组等的指南。然而，目前还存在一个问题，即如何识别高风险患者，以便在晚年发展心肌病和HF时采取一级和二级干预措施，并在左室超声心动图显示左室功能异常但无HF症状时开始治疗。没有对儿童癌症幸存者的CTRCD导致HF的治疗进行随机对照临床试验。癌症治疗引起的HF的治疗方法与普通HF的指南相似。本综述根据专家共识指南和成人HF试验的数据推断，描述了预防和治疗儿童癌症幸存者LV功能障碍和HF的最新药物疗法。© 2023. 作者，独家许可给Springer Nature Switzerland AG。

The number of childhood cancer survivors is increasing rapidly. According to American Association for Cancer Research, there are more than 750,000 childhood cancer survivors in the United States and Europe. As the number of childhood cancer survivors increases, so does cancer treatment-related cardiac dysfunction (CTRCD), leading to heart failure (HF). It has been reported that childhood cancer survivors who received anthracyclines are 15 times more likely to have late cancer treatment-related HF and have a 5-fold higher risk of death from cardiovascular (CV) disease than the general population. CV disease is the leading cause of death in childhood cancer survivors. The increasing need to manage cancer survivor patients has led to the rapid creation and adaptation of cardio-oncology. Cardio-oncology is a multidisciplinary science that monitors, treats, and prevents CTRCD. Many guidelines and position statements have been published to help diagnose and manage CTRCD, including those from the American Society of Clinical Oncology, the European Society of Cardiology, the Canadian Cardiovascular Society, the European Society of Medical Oncology, the International Late Effects of Childhood Cancer Guideline Harmonization Group, and many others. However, there remains a gap in identifying high-risk patients likely to develop cardiomyopathy and HF in later life, thus reducing primary and secondary measures being instituted, and when to start treatment when there is echocardiographic evidence of left ventricular (LV) dysfunctions without symptoms of HF. There are no randomized controlled clinical trials for treatment for CTRCD leading to HF in childhood cancer survivors. The treatment of HF due to cancer treatment is similar to the guidelines for general HF. This review describes the latest pharmacologic therapy for preventing and treating LV dysfunction and HF in childhood cancer survivors based on expert consensus guidelines and extrapolating data from adult HF trials.© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.