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Questions and Answers
What is one of the benefits of achieving a maximal killing effect in chemotherapy?
What is one of the benefits of achieving a maximal killing effect in chemotherapy?
What is included in the pre-chemotherapy assessment?
What is included in the pre-chemotherapy assessment?
Which response indicates that the chemotherapy has been completely effective?
Which response indicates that the chemotherapy has been completely effective?
Which of the following factors does NOT influence chemotherapy toxicity?
Which of the following factors does NOT influence chemotherapy toxicity?
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What condition is characterized by neither partial nor progressive criteria being met?
What condition is characterized by neither partial nor progressive criteria being met?
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Which mechanism may contribute to resistance against chemotherapy drugs?
Which mechanism may contribute to resistance against chemotherapy drugs?
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What does a partial response indicate after chemotherapy treatment?
What does a partial response indicate after chemotherapy treatment?
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Which drug class is mentioned for decreasing intracellular activation leading to resistance?
Which drug class is mentioned for decreasing intracellular activation leading to resistance?
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Which complication is most commonly associated with the use of Cisplatin in chemotherapy?
Which complication is most commonly associated with the use of Cisplatin in chemotherapy?
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What type of infusion reaction is commonly experienced with monoclonal antibody agents?
What type of infusion reaction is commonly experienced with monoclonal antibody agents?
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Which of the following is NOT a specific complication of chemotherapy?
Which of the following is NOT a specific complication of chemotherapy?
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What is a common oral complication that occurs in approximately 40% of chemotherapy patients?
What is a common oral complication that occurs in approximately 40% of chemotherapy patients?
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Which of the following drugs is associated with causing oral mucositis?
Which of the following drugs is associated with causing oral mucositis?
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What symptom is classified under skin complications due to chemotherapy with 5FU?
What symptom is classified under skin complications due to chemotherapy with 5FU?
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What management strategy may be necessary for serious infusion reactions?
What management strategy may be necessary for serious infusion reactions?
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Febrile neutropenia is a complication resulting from which type of chemotherapy effect?
Febrile neutropenia is a complication resulting from which type of chemotherapy effect?
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What is the primary purpose of adjuvant chemotherapy?
What is the primary purpose of adjuvant chemotherapy?
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Which type of chemotherapy focuses on making the distinction between cancerous and healthy tissue easier?
Which type of chemotherapy focuses on making the distinction between cancerous and healthy tissue easier?
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In which situation is induction chemotherapy used?
In which situation is induction chemotherapy used?
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What is one major advantage of neo-adjuvant chemotherapy?
What is one major advantage of neo-adjuvant chemotherapy?
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Which statement about palliative chemotherapy is true?
Which statement about palliative chemotherapy is true?
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Which type of chemotherapy is used after the surgical removal of a known tumor?
Which type of chemotherapy is used after the surgical removal of a known tumor?
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What role does radio sensitizer chemotherapy play in cancer treatment?
What role does radio sensitizer chemotherapy play in cancer treatment?
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What is the objective of maintenance chemotherapy?
What is the objective of maintenance chemotherapy?
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Which chemotherapy type is primarily aimed at controlling symptoms in patients where a cure is unlikely?
Which chemotherapy type is primarily aimed at controlling symptoms in patients where a cure is unlikely?
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What is the main goal of maintenance chemotherapy?
What is the main goal of maintenance chemotherapy?
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Which chemotherapy regimen is considered potentially curative and is utilized after previous treatments have failed?
Which chemotherapy regimen is considered potentially curative and is utilized after previous treatments have failed?
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Which of the following drugs is classified as a G1 phase-specific agent in the cell cycle?
Which of the following drugs is classified as a G1 phase-specific agent in the cell cycle?
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What is the purpose of intra-arterial perfusion in chemotherapy administration?
What is the purpose of intra-arterial perfusion in chemotherapy administration?
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Which phase of the cell cycle is associated with Vinca alkaloids?
Which phase of the cell cycle is associated with Vinca alkaloids?
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In the administration of chemotherapy, which method passes drugs through veins to target cancerous cells throughout the body?
In the administration of chemotherapy, which method passes drugs through veins to target cancerous cells throughout the body?
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How is the dose of chemotherapy typically controlled during treatment?
How is the dose of chemotherapy typically controlled during treatment?
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Which drug is most commonly associated with nephrotoxicity?
Which drug is most commonly associated with nephrotoxicity?
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Which tumor is NOT indicated for chemotherapy?
Which tumor is NOT indicated for chemotherapy?
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Which symptom is characteristic of peripheral neuropathy due to chemotherapy?
Which symptom is characteristic of peripheral neuropathy due to chemotherapy?
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What is a characteristic feature of cyclic chemotherapy?
What is a characteristic feature of cyclic chemotherapy?
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What is the typical management strategy for nausea and vomiting caused by chemotherapy?
What is the typical management strategy for nausea and vomiting caused by chemotherapy?
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Which of the following is considered to have a good response rate to chemotherapy?
Which of the following is considered to have a good response rate to chemotherapy?
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Which statement is true about combination chemotherapy?
Which statement is true about combination chemotherapy?
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Which of the following drugs is primarily linked to hypersensitivity reactions?
Which of the following drugs is primarily linked to hypersensitivity reactions?
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What is a potential drawback of continuous single-agent chemotherapy?
What is a potential drawback of continuous single-agent chemotherapy?
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What is the prognosis for secondary leukemia induced by chemotherapy agents?
What is the prognosis for secondary leukemia induced by chemotherapy agents?
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Which combination is used in the treatment of lymphoma?
Which combination is used in the treatment of lymphoma?
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Which chemotherapy agent is most commonly associated with inducing confusion as a neurological complication?
Which chemotherapy agent is most commonly associated with inducing confusion as a neurological complication?
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Which tumor type does NOT generally respond well to chemotherapy?
Which tumor type does NOT generally respond well to chemotherapy?
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What is the primary treatment option for anemia resulting from chemotherapy?
What is the primary treatment option for anemia resulting from chemotherapy?
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Which of the following is NOT a recommended preventive measure for complications of chemotherapy?
Which of the following is NOT a recommended preventive measure for complications of chemotherapy?
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What is one of the advantages of combination chemotherapy?
What is one of the advantages of combination chemotherapy?
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What therapy uses a combination of Bleomycin, Etoposide, and a Platinum-based agent?
What therapy uses a combination of Bleomycin, Etoposide, and a Platinum-based agent?
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What is the primary objective of palliative chemotherapy?
What is the primary objective of palliative chemotherapy?
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Which chemotherapy method involves administering drugs through veins, muscles, or mouth to target cancer throughout the body?
Which chemotherapy method involves administering drugs through veins, muscles, or mouth to target cancer throughout the body?
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What represents maintenance chemotherapy?
What represents maintenance chemotherapy?
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Which drug class is associated with the G1 phase of the cell cycle?
Which drug class is associated with the G1 phase of the cell cycle?
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What describes salvage chemotherapy?
What describes salvage chemotherapy?
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Which chemotherapy goal focuses on keeping cancer from spreading and slowing its growth?
Which chemotherapy goal focuses on keeping cancer from spreading and slowing its growth?
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What is the correct description of continuous suppressive therapy?
What is the correct description of continuous suppressive therapy?
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Which phase-specific agent is classified as an M phase drug?
Which phase-specific agent is classified as an M phase drug?
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What best describes a complete response to chemotherapy?
What best describes a complete response to chemotherapy?
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Which of the following statements is true regarding cancer cell resistance to chemotherapy?
Which of the following statements is true regarding cancer cell resistance to chemotherapy?
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Which parameter does NOT directly influence the toxicity of chemotherapy?
Which parameter does NOT directly influence the toxicity of chemotherapy?
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What is the primary goal of adjuvant chemotherapy?
What is the primary goal of adjuvant chemotherapy?
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Which of the following describes the purpose of neo-adjuvant chemotherapy?
Which of the following describes the purpose of neo-adjuvant chemotherapy?
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Which of the following best describes partial response after chemotherapy treatment?
Which of the following best describes partial response after chemotherapy treatment?
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Which type of chemotherapy is focused on achieving remission?
Which type of chemotherapy is focused on achieving remission?
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In the context of chemotherapy, what does stable disease indicate?
In the context of chemotherapy, what does stable disease indicate?
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Which characteristic often contributes to increased resistance to chemotherapy drugs?
Which characteristic often contributes to increased resistance to chemotherapy drugs?
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What is a complication associated with the use of adjuvant chemotherapy in adult patients with limb tumors?
What is a complication associated with the use of adjuvant chemotherapy in adult patients with limb tumors?
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Which of the following strategies is aimed at minimizing the emergence of chemotherapy-resistant cells?
Which of the following strategies is aimed at minimizing the emergence of chemotherapy-resistant cells?
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What is a characteristic advantage of radio sensitizer chemotherapy?
What is a characteristic advantage of radio sensitizer chemotherapy?
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Which factor is typically associated with increased toxicity in chemotherapy regimens?
Which factor is typically associated with increased toxicity in chemotherapy regimens?
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What would be a common indication for employing salvage chemotherapy?
What would be a common indication for employing salvage chemotherapy?
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Which chemotherapy strategy is generally not aimed at direct cancer elimination?
Which chemotherapy strategy is generally not aimed at direct cancer elimination?
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What is a significant consideration when evaluating the use of neo-adjuvant chemotherapy?
What is a significant consideration when evaluating the use of neo-adjuvant chemotherapy?
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Which type of tumor has a confirmed poor to moderate response rate to chemotherapy?
Which type of tumor has a confirmed poor to moderate response rate to chemotherapy?
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Which chemotherapy deployment method involves the administration of drugs in a cyclic manner?
Which chemotherapy deployment method involves the administration of drugs in a cyclic manner?
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What is a primary advantage of combination chemotherapy compared to single drug chemotherapy?
What is a primary advantage of combination chemotherapy compared to single drug chemotherapy?
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Which of the following combinations is used in the chemotherapy treatment of acute leukaemia?
Which of the following combinations is used in the chemotherapy treatment of acute leukaemia?
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What is a characteristic feature of continuous single agent chemotherapy?
What is a characteristic feature of continuous single agent chemotherapy?
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Which of the following tumor types is considered to have a good response rate to chemotherapy?
Which of the following tumor types is considered to have a good response rate to chemotherapy?
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Which of these statements about combination chemotherapy is NOT true?
Which of these statements about combination chemotherapy is NOT true?
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Which tumor is indicated for chemotherapy but found to have a moderate to good response rate?
Which tumor is indicated for chemotherapy but found to have a moderate to good response rate?
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Which of the following is a primary characteristic of the cyclic chemotherapy method?
Which of the following is a primary characteristic of the cyclic chemotherapy method?
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What is a drawback of using continuous single agent chemotherapy?
What is a drawback of using continuous single agent chemotherapy?
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What is a common neurological complication associated with Vincristine use?
What is a common neurological complication associated with Vincristine use?
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Which drugs are specifically noted for causing hemorrhagic cystitis?
Which drugs are specifically noted for causing hemorrhagic cystitis?
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Which complication is most directly linked with long-term use of alkylating agents like cyclophosphamide?
Which complication is most directly linked with long-term use of alkylating agents like cyclophosphamide?
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What symptom is indicative of peripheral neuropathy due to chemotherapy?
What symptom is indicative of peripheral neuropathy due to chemotherapy?
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Which class of drugs is strongly associated with immunosuppression?
Which class of drugs is strongly associated with immunosuppression?
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What is the primary treatment strategy for managing chemotherapy-induced nausea and vomiting?
What is the primary treatment strategy for managing chemotherapy-induced nausea and vomiting?
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Which of the following is a preventive strategy for anemia resulting from chemotherapy?
Which of the following is a preventive strategy for anemia resulting from chemotherapy?
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Which of these agents is linked to severe hypersensitivity reactions?
Which of these agents is linked to severe hypersensitivity reactions?
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Which complication is characterized by sloughing of the mucosa leading to diarrhea and is commonly experienced by chemotherapy patients?
Which complication is characterized by sloughing of the mucosa leading to diarrhea and is commonly experienced by chemotherapy patients?
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What is a common hematological complication caused by chemotherapy that results from bone marrow suppression?
What is a common hematological complication caused by chemotherapy that results from bone marrow suppression?
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Which drug is associated with causing hand-foot syndrome as a complication in patients undergoing chemotherapy?
Which drug is associated with causing hand-foot syndrome as a complication in patients undergoing chemotherapy?
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What type of reaction may occur during the infusion of monoclonal antibody agents such as Rituximab?
What type of reaction may occur during the infusion of monoclonal antibody agents such as Rituximab?
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Which gastrointestinal complication is a primary concern with chemotherapeutic agents like Cisplatin and Doxorubicin?
Which gastrointestinal complication is a primary concern with chemotherapeutic agents like Cisplatin and Doxorubicin?
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Which of the following is NOT classified as a non-specific complication of chemotherapy?
Which of the following is NOT classified as a non-specific complication of chemotherapy?
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What management strategy may be necessary if serious infusion reactions occur during chemotherapy treatment?
What management strategy may be necessary if serious infusion reactions occur during chemotherapy treatment?
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Which oral complication may occur in approximately 40% of patients receiving chemotherapy and involves loss of taste?
Which oral complication may occur in approximately 40% of patients receiving chemotherapy and involves loss of taste?
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Study Notes
Oncology (Medicine) - Principles of Chemotherapy
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Chemotherapy uses drugs to kill or weaken cancer cells by disrupting their growth and reproduction processes.
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Types of Chemotherapy:
- Adjuvant: Given after surgery to eliminate microscopic cancer cells and reduce recurrence risk.
- Neo-adjuvant: Given before surgery to shrink tumors and make surgical removal easier. This is especially useful for cancers of the limbs or organs; it decreases the amount of healthy tissue requiring removal, and potentially accelerates recovery time.
- Radio sensitizer: Increases the effectiveness of radiation therapy.
- Induction: Given to induce remission, typically in acute leukemia.
- Maintenance: Given after remission to prevent recurrence, with lower doses.
- Palliative: Aims to control symptoms and improve quality of life in patients with incurable cancer. It is not meant to cure the cancer.
- Salvage: Given to individuals who have not responded to or have relapsed after other treatment.
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Adjuvant Chemotherapy in Childhood Malignancies: Often a combination of surgery, radiotherapy, and chemotherapy (e.g., retinoblastoma, Wilms tumors, embryonal rhabdomyosarcoma).
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Neo-adjuvant Chemotherapy: Used for adult and childhood tumors to shrink the tumor mass prior to surgery, making surgical resection more successful. This is particularly important for cancers of the limbs or organs to decrease the amount of healthy tissue removed and potentially accelerate recovery time.
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Radio-sensitizers: Chemotherapy drugs that enhance the effects of radiation therapy.
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Induction Chemotherapy: Used to induce remission, often for acute leukemia. This often involves higher doses of chemotherapy.
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Maintenance Chemotherapy: Used after remission to prevent relapse with lower doses than the initial treatment.
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Palliative Chemotherapy: Aims to control symptoms and improve quality of life in patients with advanced or incurable cancer. It is not meant to cure the cancer. It may involve a combination of drugs.
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Salvage Chemotherapy: Given to individuals who have not responded to or have relapsed after other treatment. This may involve higher doses or different drugs.
Cell Cycle Phase Specific Agents
- Chemotherapy drugs target specific phases of the cell cycle, for example:
- S-phase: Capecitabine, 5-FU, Methotrexate.
- M-phase: Vinca alkaloids, Taxanes
- G2 phase: Bleomycin
- G1 phase: Corticosteroids
Goals of Chemotherapy
- To cure cancer with minimal harm.
- To slow or stop cancer spread.
- To alleviate cancer-related symptoms like pain.
Chemotherapy Administration
- Intra-arterial perfusion: Effective against local tumors with potential for less systemic toxicity compared to some systemic therapies.
- Regional perfusion: Delivery of chemotherapy directly to a tumor region, bypassing the entire body for maximized drug delivery to the tumor and potentially reduced effects on non-target tissues.
- Systemic chemotherapy: Drugs are circulated throughout the body to reach cancerous cells, but toxicity can affect healthy tissues.
Chemotherapy Indications
- Breast cancer
- Head and neck tumors
- Stomach cancer
- Bladder, prostate, ovarian, cholangio-cellular, anal cancers, and others
Chemotherapy Deployment
- Continuous single agent: Less effective in the modern era compared to other methods due to lower response rates and higher potential for resistance development.
- Cyclic chemotherapy: Drugs given in cycles help reduce resistance.
- Combination chemotherapy: Combining different drugs potentiates efficacy and decreases resistance.
Common Chemotherapy Regimens (Examples)
- MOPP: Used for lymphoma
- CVP: Used for acute leukemia
- CMF: Used for breast cancer
- BEP: Used for testicular tumors
Pre-chemotherapy Assessment
- Accurate diagnosis and staging for effective treatment planning. This involves a detailed medical history, physical examination, imaging, and tumor markers.
- Crucial for efficient treatment plan design and to avoid unnecessary trials of chemotherapeutic agents.
Response to Chemotherapy (WHO Criteria)
- Complete Response (CR) - total disappearance of the cancer.
- Partial Response (PR) - 50% or greater reduction in tumor size.
- Progressive Disease (PD) - noticeable increase in tumor size, or appearance of new tumors.
- Stable Disease (SD) - no significant change in size or spread of the cancer.
Resistance to Chemotherapy
- Cancer cells may adapt and develop resistance to the drugs over time. (e.g., genetic instability). This resistance can often lead to treatment failure.
- Increase in cellular hypoxia (lack of oxygen) may hinder the effectiveness of certain drugs like methotrexate, 6MP, and Asparaginase.
Chemotherapy Toxicity
- Non-specific: skin, hematological, gastrointestinal, neurological, and ototoxicity; these toxicities affect healthy tissues.
- Specific: damage to particular organ systems (e.g., cardiomyopathy).
- Infusion reactions: Common with some monoclonal antibody agents.
- Skin complications: alopecia, skin darkening, hand-foot syndrome (with specific drugs).
Other complications
- Hematological: anemia, leukopenia (low white blood count), thrombocytopenia (low platelet count).
- Gastrointestinal (GIT): nausea/vomiting (often triggered by sight/smell), mucositis, diarrhea.
- Oral: Loss of taste, appetite, and simple oral mucositis.
- Neurological: confusion, peripheral neuropathy.
- Renal: nephrotoxicity (kidney damage).
- Secondary leukemia: May be a long-term adverse effect from alkylating agents.
- Immunological: hypersensitivity responses, immunosuppression.
Prevention and Management of Complications
- Varying foods, medication (e.g., antiemetics, corticosteroids to reduce nausea), blood transfusions to correct anemia, nutrition supplements, oral hygiene, managing nausea, and providing supportive care. These preventive and management strategies are crucial for a patient's comfort and successful treatment.
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