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首页> 外文期刊>European Heart Journal: The Journal of the European Society of Cardiology >Geriatric congenital heart disease: a new challenge in the care of adults with congenital heart disease?
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Geriatric congenital heart disease: a new challenge in the care of adults with congenital heart disease?

机译：老年先天性心脏病：成人先天性心脏病的护理面临新挑战吗？

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While conventional chemotherapy regimens aim to be cytotoxic against proliferating cells, molecular targeted therapies are directed at specific cancer-associated pathways. To optimize cancer care, an early evaluation of treatment response is warranted for any tumor type - and for any treatment - by using conventional imaging modalities such as ultrasound, CT and MR, FDG-PET or specific radiotracer. FDG-PET is one of the most extensively and successfully used imaging modalities to achieve an early response evaluation. A high SUV-value is a surrogate for malignancy in terms of cancer care and a decrease in FDG-uptake after therapy is associated with treatment response and a favorable clinical outcome. Anyhow, the potential of PET reaches further. By providing metabolic information PET (with or without CT) can help to select patients for targeted therapy and to adapt treatment protocols. PET with FDG and maybe other, more specific PET tracers, promises to direct in a better way personalized cancer care and thus promote translational research. An interesting aspect of molecular imaging is the ability to achieve knowledge on distribution and expression levels of a given receptor. Hereby, imaging could help in guiding systemic treatment given a broad spectrum of radiotracers, detecting specific mutations at molecular level in vivo. From an oncologists point of view the concept of 'personalized medicine' should evolve to include 'personalized imaging' as well as 'personalized treatment' in order to optimize cancer care, reduce side effects and improve quality of life for cancer patients.
机译：传统的化学疗法旨在针对增殖细胞具有细胞毒性，而分子靶向疗法则针对特定的癌症相关途径。为了优化癌症护理，需要通过使用常规成像方式（例如超声，CT和MR，FDG-PET或特定的放射性示踪剂）对任何类型的肿瘤-和任何治疗方案进行早期评估。 FDG-PET是最广泛且成功使用的成像方式之一，可实现早期响应评估。在癌症护理方面，高SUV值是恶性肿瘤的替代指标，治疗后FDG摄取的减少与治疗反应和良好的临床疗效相关。无论如何，PET的潜力将进一步扩大。通过提供代谢信息，PET（带或不带CT）可以帮助选择患者进行靶向治疗和调整治疗方案。带有FDG的PET以及其他更具体的PET示踪剂，有望以更好的方式指导个性化癌症治疗，从而促进转化研究。分子成像的一个有趣方面是能够获得有关给定受体的分布和表达水平的知识。因此，鉴于放射性示踪剂的广谱性，成像可以帮助指导全身治疗，从而在体内检测分子水平的特定突变。从肿瘤学家的角度来看，“个性化医学”的概念应发展为包括“个性化影像”和“个性化治疗”，以优化癌症治疗，减少副作用并改善癌症患者的生活质量。

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