Chemotherapy antineoplastic

Cancer or neoplastic disease is a genomic disorder of the body s own cells which start to proliferate and metastasize in an uncontrolled fashion that is ultimately detrimental to the individual. Antineoplastic agents are used in conjunction with surgery and radiotherapy to restrain that growth with curative or palliative intention. The domain of antineoplastic chemotherapy is cancer that is disseminated and therefore not amenable to local treatment modalities such as surgery and radiotherapy. 

Cancer treatment is a multimodality treatment, i.e., surgery is combined with radiotherapy and antineoplastic chemotherapy. The latter treatment mode is used mainly for cancers which have disseminated. Different forms of cancer differ in their sensitivity to chemotherapy with antineoplastic agents. The most responsive include lymphomas, leukemias, choriocarcinoma and testicular carcinoma, while solid tumors such as colorectal, pancreatic and squamous cell bronchial carcinomas generally show a poor response. The clinical use of antineoplastic agents is characterized by the following principles. 

Patients receiving cytotoxic chemotherapy very often need concomitant administrating of antiemetic therapy. Such protocols will start well in advance of administering the cytotoxic, and last for a reasonable time with regard to pharmacokinetics of the antineoplastic agent. In addition, side effects of antineoplastic therapy are made better tolerable by supportive care. 

The nurse reviews the results of all laboratory tests at the time they are reported. The primary health care provider is notified of the results before the administration of successive doses of an antineoplastic drug. If these tests indicate a severe depressant effect on the bone marrow or other test abnormalities, the primary health care provider may reduce the next drug dose or temporarily stop chemotherapy to allow the affected body systems to recover. 

Most hospitals and clinics require that nurses receive specialized training and standardized educational preparation before they are permitted to administer antineoplastic drug s. The Oncology Nursing Society has developed guidelines and educational tools for creden-tialing nurses for certification in administering chemotherapy. 

Raynal, N.J., Bernstein, M.L. and Momparler, R.L. (2009) Inhibition of cytidine deaminase by zebularine enhances the antineoplastic action of5-aza-2 -deoxycytidine. Cancer Chemotherapy and Pharmacology, 63, 411-416. 

Other Methotrexate also is indicated as an antineoplastic chemotherapy in various types of cancers and acute lymphocytic leukemia. 

Thomson AJ, Mansy S. In Advances in Antimicrobial and Antineoplastic Chemotherapy Vol. IIL 1972 Baltimore University Press Baltimore, pp. 199-203. 

Adjuvant chemotherapy involves the use of antineoplastic drugs when surgery or radiation therapy has eradicated the primary tumor but historical experience with similar patients indicates a high risk of relapse due to micrometastases. Adjuvant chemotherapy should employ drugs that are known to be effective in the treatment of advanced stages of the particular tumor being treated. Adjuvant chemotherapy has played a major role in the cure of several types of childhood cancers as well as breast cancer, colorectal cancer, and osteosarcoma in adults. 

Neurotoxicity is rarely dose hmiting in cancer chemotherapy. The only antineoplastic agent that has a dose-limiting neurotoxicity is... 

Bacon DR, Nuzzo RJ. Anthracycline antineoplastic chemotherapy agents anesthetic implications. Semin Anesth 1993 12 74-8. 

PI Thrum, H. Haupt, I. Bradler, G. Zimmer, C. Reinert, K. E., In Advances in Antimicrobial Antineoplastic Chemotherapy, University Park Press Baltimore, MD, (1972) p 819. 

Originally developed for chemotherapy, azathioprine is used today mainly as an immunosuppressive agent and rarely as an antineoplastic drug. It was introduced as an immunosuppressive agent by a British pioneer of tissue transplantation, Roy Caine. Azathioprine was used to prevent rejection after tissue transplantation as a replacement for 6-mercaptopurine because it was less toxic. In addition to tissue transplantation, it is also used for rheumatoid arthritis and Crohn s disease. Azathioprine is a prodrug which in the body is converted to its active metabolites 6-mercaptopurine and 6-thioinosinic acid. Until the discovery of cyclosporine, azathioprine in combination with steroids was the standard treatment to prevent rejection after tissue transplantation. 

Various forms of cancer exhibit a broad spectrum of response to antineoplastic medications. Some forms of cancer (choriocarcinoma, Wilms tumor) can be cured in more than 90 percent of affected patients. In other neoplastic disorders, chemotherapy may not cure the disease but may succeed in mediating remission and prolonging survival in a large patient percentage. Of course, other factors such as early detection and the concomitant use of other interventions (surgery, radiation) will greatly influence the success of chemotherapy drugs. 

Oxidative stress reduces the rate of cell proliferation, and that occurring during chemotherapy may interfere with the cytotoxic effects of antineoplastic drugs, which depend on rapid proliferation of cancer cells for optimal activity. Antioxidants detoxify ROS and may enhance the anticancer effects of chemotherapy. For some supplements, activities beyond their antioxidant properties, such as inhibition of topoisomerase II or protein tyrosine kinases, may also contribute. ROS cause or contribute to certain side effects that are common to many anticancer drugs, such as gastrointestinal toxicity and muagenesis. ROS also contribute to side effects that occur only with individual agents, such as doxorubicin-induced cardiotoxicity, cisplatin-induced nephrotoxicity, and bleomycin-induced pulmonary fibrosis. Antioxidants can reduce or prevent many of these side effects, and for some supplements the protective effect results from activities other than their antioxidant properties. Certain side effects, however, such as alopecia and myelosuppression, are not prevented... 

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