口腔颌面外科学 第八章 口腔颌面部肿瘤、口腔颌面外科学 口腔颌面部肿瘤总论_口腔颌面外科学_ff808081-29587567-0129-5875af1f-0610.pptVIP

Chemotherapy One of the main technologies against cancer Definition Not curative, used only as an adjunct First applied in 1946 Used to: Cure cancer Control cancer Relieve symptoms cancer can cause Usually used in addition with the other treatments Can be given: At home Dr.’s office Clinic Outpatient dept. As an inpatient in a hospital Classification of chemotherapy drugs Chemical structure cell cycle the drug interrupts Protocol of chemotherapy mono drug and combination drug Side effect of chemotherapy Cell and Tumor Kinetics G1 synthesis RNA S DNA synthesis G2 synthesis of mitotic spindle G0 rest M mitosis Chemotherapeutic Agents Alkylating agents(烷化剂) Antimetabolites(抗代谢类) Antitumor Antibiotics(抗生素) Steroid hormones(激素类) Plant Alkaloids(植物类) Alkylating Agents Link to DNA bases – stop replication Nitrogen Mustards, HN2 Cyclophosphamide, CTX Antimetabolites Inhibit synthesis of bases Methotrexate 5-Fluorouracil Antitumor antibiotics Pingyangmycin Bleomycin Adriamycin Mitomycin Actinomycin D Hormones Prednisone Estrogen Testosterone Plant Alkaloids Disrupt mitotic spindle during M phase (cell cycle phase specific) Vinca Alkaloids Camptothecins Taxanes Cell Cycle Cell Cycle Specific Agents Antimetabolites Bleomycin Podophyllin Alkaloids Plant Alkaloids Cell Cycle Non-Specific Agents Alkylating Agents Antibiotics Cisplatin Nitrosoureas Chemotherapy Protocol Often combination of agents Different modes of action Reduced chance of resistance Reduced toxicity Often combined with other treatments (Adjuvant) Pre Reduce tumour load Post Reduce sub-clinical disease Combination Chemotherapy more effective than single agent additive antitumor effects without additive host toxicity delayed resistance to drugs Use Rapidly dividing tumours most susceptible Balance between efficacy and toxicity Side effect of chemotherapy myelosuppression, low blood cell counts gastrointestinal tract problems hair loss skin rashes fatigue infertility