Type:
Educational Exhibit
Keywords:
Radiation effects, Complications, Chemotherapy, CT, Oncology, Thorax, Abdomen, Multidisciplinary cancer care, Toxicity
Authors:
J. Hu, A. Campagnola, M. C. Ambrosetti, G. A. Zamboni, G. Mansueto; Verona/IT
DOI:
10.26044/ecr2019/C-1510
Background
Currently cancer therapy can take advantage of a multimodal approach,
which has improved the expectation and quality of life of patients,
based on the combination of chemo-,
immuno- and radio-therapy.
Advances in pharmaceuticals and knowledge of cancer biology have led to the fact that chemotherapy,
to date,
is no longer based only on cytotoxic agents,
but also on new drugs,
able to act more selectively towards specific mutations of neoplastic cells.
Classical cytotoxic chemotherapy is based on drugs that act by interfering on the synthesis of DNA and RNA or on cell replication,
creating too severe damage to the cell to be repaired and leading to cell death or apoptosis.
These drugs tend to interfere not only with the replication of neoplastic cells,
but also with that of healthy cells that rapidly divide as intestinal cells and bone marrow,
with subsequent gastrointestinal toxicity and myelosuppression.
The new molecular therapies or target therapy are classified according to their mechanism of action (monoclonal antibodies,
tyrosine kinase inhibitors,
immunotherapeutic cytokines,
immunomodulators,
drugs that target specific intracellular molecules) and present a range of less predictable side effects,
going to interfere with multiple targets,
some of them critical,
to normal cellular function.
An increased risk of side effects is associated with this greater therapeutic effect.
Complications depend not only on the effect of the single drug,
but also on the synergy of multiple therapies and patient’s predisposition (infections,
previous surgery,
chronic diseases such as hypertension,
diabetes and atherosclerosis).
Side effects should not be confused with disease progression.