Combined radiotherapy and chemotherapy
Michael C. Joiner, Albert J. van der Kogel in Basic Clinical Radiobiology, 2018
Classically, cytotoxic anti-neoplastic drugs are divided into different classes based on their mechanisms of action, i.e. anti-metabolites, alkylating agents, topoisomerase inhibitors, anti-microtubule agents and antibiotics. Compared to radiotherapy or surgery, chemotherapy is a systemic treatment administered mainly intravenously or orally. Chemotherapy agents are used alone (monochemotherapy) or in combination (polychemotherapy). Typically, chemotherapeutic agents are biologically active by killing dividing cells, thus exerting both their efficacy and their toxicity (Table 19.2). The main side effects typically observed with chemotherapy, but with important variations in intensity from one drug to another, include nausea, vomiting, alopecia, mucositis, fatigue, anaemia, thrombopenia and neutropenia. In addition, some specific toxicities can be observed with specific agents (e.g. cardiac dysfunction with anthracyclines, bladder toxicity with ifosfamide). Table 19.2 describes the main cytotoxic agents with their biological activity and specific toxicities.
Oncology
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
These drugs are classed as antineoplastics and are often referred to as cytotoxic agents since their use in cancer treatment is to destroy the abnormal cells. Hormonal therapy is employed to treat tumors that arise from hormonally mediated tissues such as the breast, prostate, and endometrium. Chemotherapeutic regimens of multiple agents are often used and are commonly referred to by abbreviations listed in Table 18.3 A number of adverse effects on various parts of the body are associated with the use of these antineoplastic drugs. Some of the terms frequently associated with these adverse effects are listed in Table 18.4
A Review on Medicinal Plants used in Cardioprotective Remedies in Traditional Medicine
Anne George, Oluwatobi Samuel Oluwafemi, Blessy Joseph, Sabu Thomas, Sebastian Mathew, V. Raji in Holistic Healthcare, 2017
Cardiovascular toxicity can be induced by various antineoplastic drugs. Anthracyclines are the best recognized agents, which cause cardiac damage (Table 11.3). Doxorubicin (DOX)/Adriamycin (trade name for DOX) and other anthracyclines are widely used in cancer treatment. DOX is a potent antitumor drug, but its clinical use is limited due to cardiotoxicity. DOX treatment induces morphological changes in heart mitochondria. It inhibits cytochrome oxidase as binding to cardiolipin.46 The mechanism underlying DOX induced cardiotoxicity include: free radical generation, impaired adrenergic regulation, the release of vasoactive amines, and the suppression of muscle specific genes.47 Other possible mechanisms are the induction of apoptosis, changes in lipid profile, mitochondrial DNA damage, changes in ATP production, downregulation of mRNA, expression for sarcoplasmic reticulum calcium ATPase, and histological changes in the myocardium.48
Severity and 1-month outcome of SARS-CoV-2 infection in patients with solid cancers: a Danish nationwide cohort study
Published in Acta Oncologica, 2021
S. Ehmsen, L. H. Jakobsen, M. E. Lendorf, R. L. Eefsen, L. Bentsen, A. S. Knoop, N. Aggerholm-Pedersen, H. Skuladottir, J. Herrstedt, L. H. Jensen, C. Rotbøl, M. B. Damm, K. Wedervang, A. Glenthøj, J. Ryg, H. Frederiksen, A. R. Kodahl
Baseline data included age, sex, height, weight, Eastern Cooperative Oncology Group (ECOG) performance status (PS), home care, type of malignancy, cancer status (remission, stable or progressive disease), comorbidity, current and previous anticancer therapy, and current medication at the time of SARS-CoV-2 infection. Comorbidities were summarized using the Charlson Comorbidity Index (CCI) [18]. Individual comorbid conditions of particular interest concerning SARS-CoV-2, such as diabetes and obesity (body mass index ≥ 30) were also registered [7,18]. Recent therapy refers to cancer treatment given within four weeks (28 days) of a positive test for SARS-CoV-2. Active antineoplastic therapy included cytotoxic chemotherapy and other anticancer therapies (targeted drugs, endocrine therapy, immunotherapy, radiotherapy).
Protective effect of myricetin, apigenin, and hesperidin pretreatments on cyclophosphamide-induced immunosuppression
Published in Immunopharmacology and Immunotoxicology, 2021
Mehmet Berköz, Serap Yalın, Ferbal Özkan-Yılmaz, Arzu Özlüer-Hunt, Mirosław Krośniak, Renata Francik, Oruç Yunusoğlu, Abdullah Adıyaman, Hava Gezici, Ayhan Yiğit, Seda Ünal, Davut Volkan, Metin Yıldırım
Chemotherapy is widely used for the treatment of cancer, and the major impacts of chemotherapy are nausea, fatigue, and immunosuppression. Chemotherapy drugs are not only targeted to destroy rapidly dividing cancer cells but also they destroy normal cells in blood, bone marrow, etc. The mechanism behind the immunosuppression of a chemotherapy drug is that it can affect the bone marrow, in turn causing it to lose the ability to produce healthy immune cells [1]. Cyclophosphamide is a common chemotherapeutic agent used to treat various types of cancers and autoimmune disorders but the major side effects of cyclophosphamide administration are immunosuppression and myelosuppression, which occur due to the arrest of proliferation of healthy immune cells. The immunosuppressive effect of cyclophosphamide is mediated by the phosphoramide mustard and acrolein, which are formed during the activation of cyclophosphamide by the catalyst hepatic cytochrome P450 enzyme [2] . The activated cyclophosphamide can kill and destroy the cancer cells by inducing oxidative stress. The oxidative stress can damage normal immune cells due to their high polyunsaturated fatty acids levels in their membranes [1,2]. The oxidative stress conditions can increase the level of reactive oxygen species (ROS) and it can directly affect both the cellular and humoral components. Therefore, it is essential to enhance the body immune system against oxidative stress [3].
Ameliorative effects of hexane extract of Garcinia kola seeds Heckel (Clusiaceae) in cisplatin-induced hepatorenal toxicity in mice
Published in Drug and Chemical Toxicology, 2022
Adeniyi Folayan, Emmanuel Akani, Olayinka A. Adebayo, Olubukola O. Akanni, Solomon E. Owumi, Abiola S. Tijani, Oluwatosin A. Adaramoye
Chemotherapy and radiotherapy have emerged as the most common modalities of cancer treatment (Jin et al.2015). Due to the effectiveness and non-selectivity of many antineoplastic drugs, severe adverse effects such as destruction of healthy cells, tiredness, immunosuppression, bleeding, irritation of gastrointestinal tract, hair loss, and specific organ damage are common during chemotherapy. Cisplatin, an anticancer agent, is a universally used drug for the management of many solid tumors (Rabik and Dolan 2007). The wide acceptability of Cisplatin in cancer treatment is restricted due to its toxicity, which includes hepatotoxicity, nephrotoxicity, and neurotoxicity (Ali et al.2015). Studies revealed that cisplatin toxicity is mediated via reactive oxygen species generation (Almaghrabi 2015). Hence, a significant reduction in the degree of cisplatin toxicity has been achieved by the use of antioxidants (Aksoy et al.2015). Therefore, the search for safe and effective chemoprotective agents to mitigate cisplatin-induced toxicity is still an active area of research.
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