Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Oral Delivery of DMAB-Modified DocetaxelLoaded PLGA-TPGS Nanoparticles for Cancer Chemotherapy
It has been said that the control of disease has three goals, which, in
increasing order of attraction are palliation, cure, and prevention. For most types
of disseminated cancer, medical science has achieved only the first of these
objectives, while for some malignancies the side effects of the therapeutic agents
employed rival the disease itself in precluding a desirable quality of life.
Making a Treatment Plan From information on the extent of disease and the prognosis and in conjunction with the patient's wishes, it is determined whether the treatment approach should be curative or palliative in intent. Cooperation among the various professionals involved in cancer treatment is of the utmost importance in treatment planning.
Table 81-2 Commonly Used Cancer Chemotherapy Agents
Exam ples of Usual Doses
Direct DNA-Interacting Agents
Liver metabolism required
phosphoramide 100 mg/m2 PO qd Common alkylatora Mesna protects Cardiac dose) against Cystitis mustard + acrolein
(high "high-dose" bladder damage
6 mg/m2 IV day
Topical use in cutaneous lymphoma
Vesicant 1 and day 8 Nausea
1–3 mg/m2 qd PO
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: " A novel human ex vivo model for the analysis of molecular events during lung cancer chemotherapy...
The ATP-binding cassette (ABC) transporters are a superfamily of mem-brane proteins that are best known for their ability to transport a wide
variety of exogenous and endogenous substances across membranes against
a concentration gradient via ATP hydrolysis.
This second edition of Breast Cancer continues the tradition of the M. D.Anderson Cancer Care Series. The book is oriented towards the needs of clinicians who manage breast cancer at every stage of the disease. Chapters are written by experts with a strong knowledge of research findings who also are active in the clinic and understand the practical needs of the patient and her physician.
Harrison's Internal Medicine Chapter 82. Infections in Patients with Cancer
Infections in Patients with Cancer: Introduction Infections are a common cause of death and an even more common cause of morbidity in patients with a wide variety of neoplasms. Autopsy studies show that most deaths from acute leukemia and half of deaths from lymphoma are caused directly by infection. With more intensive chemotherapy, patients with solid tumors have also become more likely to die of infection.
Chemoprevention β-Carotene and cis-retinoic acid can lead to the regression of leukoplakia. However, cis-retinoic acid does not reduce the incidence of second primaries
Complications from treatment of head and neck cancer are usually correlated to the extent of surgery and exposure of normal tissue structures to radiation. Currently, the extent of surgery has been limited or completely replaced by chemotherapy and radiation therapy as the primary approach. Acute complications of radiation include mucositis and dysphagia.
Until recently, surgical resection was considered the only option for treatment of kidney
cancer, especially renal cell carcinoma. The disease is relatively resistant to both radiotherapy
and chemotherapy, and although alternative systemic therapies such as interleukin-
2 immunotherapy and interferon have shown promise, objective response rates are
still quite low. Minimally invasive therapies have piqued the interest of researchers by
showing significant improvements in treatment and management of kidney cancer.
Harrison's Internal Medicine Chapter 77. Approach to the Patient with Cancer
Approach to the Patient with Cancer: Introduction The application of current treatment techniques (surgery, radiation therapy, chemotherapy, and biological therapy) results in the cure of nearly two of three patients diagnosed with cancer. Nevertheless, patients experience the diagnosis of cancer as one of the most traumatic and revolutionary events that has ever happened to them.
Induction of p53 by the DNA damage and oncogene checkpoints.
In response to noxious stimuli, p53 and mdm2 are phosphorylated by the ataxia telangiectasia mutated (ATM) and related ATR serine/threonine kinases, as well as the immediated downstream checkpoint kinases, Chk1 and Chk2. This causes dissociation of p53 from mdm2, leading to increased p53 protein levels and transcription of genes leading to cell cycle arrest (p21Cip1/Waf1) or apoptosis (e.g., the proapoptotic Bcl-2 family members Noxa and Puma).
Pain Pain occurs with variable frequency in the cancer patient: 25–50% of patients present with pain at diagnosis, 33% have pain associated with treatment, and 75% have pain with progressive disease. The pain may have several causes. In ~70% of cases, pain is caused by the tumor itself—by invasion of bone, nerves, blood vessels, or mucous membranes or obstruction of a hollow viscus or duct.
Principles of Chemotherapy Medical oncology is the subspecialty of internal medicine that cares for and designs treatment approaches to patients with cancer, in conjunction with surgical and radiation oncologists. The core skills of the medical oncologist include the use of drugs that may have a beneficial effect on the natural history of the patient's illness or favorably influence the patient's quality of life. In general, the curability of a tumor is inversely related to tumor volume and directly related to drug dose.
The level of suspicion of infections with certain organisms should depend on the type of cancer diagnosed (Table 82-3). Diagnosis of multiple myeloma or CLL should alert the clinician to the possibility of hypogammaglobulinemia. While immunoglobulin replacement therapy can be effective, in most cases prophylactic antibiotics are a cheaper, more convenient method of eliminating bacterial infections in CLL patients with hypogammaglobulinemia.
Typhlitis Typhlitis (also referred to as necrotizing colitis, neutropenic colitis, necrotizing enteropathy, ileocecal syndrome, and cecitis) is a clinical syndrome of fever and right-lower-quadrant tenderness in an immunosuppressed host. This syndrome is classically seen in neutropenic patients after chemotherapy with cytotoxic drugs.
Pancreatic Cancer: Treatment Symptoms and the associated impaired performance status are significant issues in the management of patients with pancreatic cancer, as they can have a marked negative impact on the ability to safely deliver chemotherapy or perform curative surgery. For example, patients with malabsorption secondary to pancreatic insufficiency may be treated with pancreatic enzyme supplementation. Indeed effective symptom management is as important a therapeutic goal as survival prolongation.
Postchemotherapy Surgery Resection of residual metastases after the completion of chemotherapy is an integral part of therapy. If the initial histology is nonseminoma and the marker values have normalized, all sites of residual disease should be resected. In general, residual retroperitoneal disease requires a modified bilateral RPLND.
Thoracotomy (unilateral or bilateral) and neck dissection are less frequently required to remove residual mediastinal, pulmonary parenchymal, or cervical nodal disease.
Application to Patients
Radiation therapy can be used alone or together with chemotherapy to produce cure of localized tumors and control of the primary site of disease in tumors that have disseminated. Therapy is planned based on the use of a simulator with the treatment field or fields designed to accommodate an individual patient's anatomic features. Individualized treatment planning employs lead shielding tailored to shape the field and limit the radiation exposure of normal tissue. Often the radiation is delivered from two or three different positions.
Primary prophylaxis (i.e., shortly after completing chemotherapy to reduce the nadir) of G-CSF to patients receiving cytotoxic regimens is associated with a 20% incidence of febrile neutropenia. "Dose-dense" regimens, where cycling of chemotherapy is intended to be completed without delay of administered doses, may also benefit, but such patients should be on a clinical trial. Administration of G-CSF in these circumstances has reduced the incidence of febrile neutropenia in several studies by about 50%.