Prevention and treatment of cardiotoxicity in patients with colorectal cancer

Background. Colorectal cancer is one of the most common oncological diseases both worldwide and in our country. In the Russian Federation, this pathology accounts for 12% of all malignant neoplasms. The development of modern strategies for the diagnosis and treatment of patients with colorectal cancer has contributed to increased survival in this patient group. Consequently, mortality from non-cancer causes, particularly cardiovascular diseases is rising. Aggressive anti-tumor therapy increases the risk of cardiotoxicity, which, when it occurs, significantly worsens the prognosis of the primary disease. Objective. To examine current studies and articles on the prevention and treatment of cardiotoxicity in patients with colorectal cancer. Materials and methods. This study analyzed publications on the prevention and treatment of cardiotoxicity in patients with colorectal cancer using Scopus, PubMed, elibrary.ru, and Google Scholar databases. Results. This article presents data on the frequency of cardiovascular complications in patients receiving various chemotherapeutic drugs for colorectal cancer (fluoropyrimidines, platinum derivatives, vascular endothelial growth factor inhibitors, epidermal growth factor receptor inhibitors, multikinase inhibitors). It emphasizes the importance of cardiovascular risk assessment before initiating anti-cancer therapy and reviews various risk stratification scales for cardiotoxicity. However, no validated scales have been developed to specifically determine the cardiotoxic risk in patients with colorectal cancer. The article discusses key strategies for preventing the most common cardiovascular complications (ischemic heart disease, arterial hypertension, heart failure, arrhythmias) during treatment for colorectal cancer. Special attention is paid to the need for correction of traditional cardiovascular risk factors and the potential use of various cardioprotective drugs for prophylactic purposes. Necessary laboratory and instrumental monitoring methods for the early detection of signs of cardiotoxicity are outlined. The main approaches to the treatment of cardiotoxicity in this patient group are also considered. Conclusions. Prevention and treatment of cardiotoxicity in colorectal cancer are important aspects of improving the overall effectiveness of therapy, prolonging survival, and improving quality of life for patients. Particular attention should be paid to a multidisciplinary approach when managing this group of patients.