Cancer Chemotherapy by u7pZT6rp

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									Cancer
Chemotherapy



               Dr.Azarm
 The goal of cancer treatment is
  eradication of cancer
 If not possible shifts to palliation
  ,amelioration and preservation of quality
  of life




                                    Dr.Azarm
   Surgery
   Radiotherapy
   Chemotherapy
   Biologic therapy




                       Dr.Azarm
Diagnosis

  Pathology
  Tumor markers ; germ cell tumors ,




                                        Dr.Azarm
Staging

  Clinical
  Pathologic




                Dr.Azarm
Surgery

  Curative
  Palliative
Radiation
  Ionization and excitation of atoms and bombs
   that kills cells
  Cell killing ,nausea , vomiting ,fatigue ,
   somnolence
  Late effect ;fibrosis and gliosis
  Skin and mucosal reactions are accentuated
   by other modalities like chemotherapy
  Acute response , subacute response , late
   response
  Definitive , adjuvant , palliative
Chemotherapy
Chemotherapy
                                        9
 Clinically detectable tumor : 1 × 10 cell
  =1 cm
 Mechanism of drugs : apoptosis ,
  pproliferation control , affect maturation ,
  angiogenesis ,
Chemotherapy for what ??

  Cure malignancies or improve survival
  Palliate symptoms
  Organ preserving
Types of chemotherapy

  Adjuvant
  Neoadjuvant
  Palliative
Type of administration

  Oral
  IV
  Intracavitary
Intravenous

  Vein selection
  Irritant : without necrosis ,BCNU ,cisplatin
   ,dacarbazine , etoposide , vinca alkaloids
  Vesicant : necrosis , antrscyclines ,
   dactinomycine , nitrogen mustard
     Complications of
      chemotherapy
 Myelosuppression
 Gastrointestinal toxicity : nausea and
  vomiting , mucositis , diarrhea
 Abnormal renal function : cisplatin , MTX
 Hepatotoxicity : vinca alkaloids ,
  antracyclines
Specific toxicity
  Alkylating agents : carcinogen ,
  busulfan ; irreversible myelosuppression
  chlorambucil ; the least toxic alkylating agent
  cyclophosphamide ; hemorrhagic cystitis , bladder
    carcinoma ,alopecia ,aspermia , amenorrhea ,
  Ifosfamide ; hemorrhagic cystitis ,alopecia
  cisplatin ; renal insufficiency ,neuropathy ,ototoxicity ,
    severe nausea and vomiting
  carboplatin ;
Specific toxicity

  Antimetabolites ;
  cytosar ; cerebellar toxicity ,conjuctivitis
  5-FU ; mucositis , diarrhea ,
  capecitabine ( xeloda ) : diarrhea , hand-
   foot syndrome
  MTX ; mucositis , impaired renal function ,
   myelosuppression ,
Specific toxicity

  Antitumor antibiotics ;
   bleomycin ; pulmonary fibrosis ,
   anaphylaxis ,
   anthracyclines ; cardiotoxicity , allopecia
Specific toxicity

  Mitotic spindle agents ;
   vincristin , vinblastin ; neuropathy
   taxane ; hypersensitivity , alopecia ,
   peripheral neuropathy
Specific toxicity

  Topoisomerase inhibitors ;
   etoposide ,irinotecan
Specific toxicity

  Tyrosin kinase inhibitors ;
  gefitinib ( Iressa )
  imatinib ( gleevec )
Specific toxicity

  Monoclonal antibodies ;
   relative selectivity for tumor ,cytokine
   release syndrome ( fevfr , hypotension ,
   bronchospasm ) ,
   Rituximab , Trastuzumab , Alemtuzumab
   ,Bevacizumab
Growth factors

  Erythropoetin
  G-csf
  Plt growth factor

								
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