tailieunhanh - Chapter 081. Principles of Cancer Treatment (Part 8)

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. End Points of Drug Action Chemotherapy agents may be used for the treatment of active, clinically apparent cancer. Table. | Chapter 081. Principles of Cancer Treatment Part 8 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. End Points of Drug Action Chemotherapy agents may be used for the treatment of active clinically apparent cancer. Table 81-1 A lists those tumors considered curable by conventionally available chemotherapeutic agents when used to address disseminated or metastatic cancers. If a tumor is localized to a single site serious consideration of surgery or primary radiation therapy should be given as these treatment modalities may be curative as local treatments. Chemotherapy may be employed after the failure of these modalities to eradicate a local tumor or as part of multimodality approaches to offer primary treatment to a clinically localized tumor. In this event it can allow organ preservation when given with radiation as in the larynx or other upper airway sites or sensitize tumors to radiation when given for example to patients concurrently receiving radiation for lung or cervix cancer Table 81-1 B . Chemotherapy can be administered as an adjuvant . in addition to surgery Table 81-1 C or radiation after all clinically apparent disease has been removed. This use of chemotherapy may have curative potential in breast and colorectal neoplasms as it attempts to eliminate clinically unapparent tumor that may have already disseminated. As noted above small tumors frequently have high growth fractions and therefore may be intrinsically more susceptible to the action of antiproliferative agents. Chemotherapy