Chemotherapy is a method of treating cancer using chemical drugs, primarily by inhibiting the division and growth of cancer cells to achieve therapeutic effects. This treatment is commonly used for various malignant tumors, including hematologic cancers and solid tumors, and can be used alone or in combination with surgery, radiation therapy, and other modalities. The core principle involves selectively killing rapidly dividing cells with drugs, but it may also affect normal cells, thus requiring strict control of dosage and treatment cycles.
The goals of chemotherapy include shrinking tumors, delaying disease progression, or reducing the risk of recurrence before and after surgery. In recent years, with advances in drug development, treatment strategies have shifted toward personalized medicine, adjusting plans based on patient constitution and tumor characteristics.
Chemotherapy drugs are mainly divided into cytotoxic drugs and targeted therapy drugs. Cytotoxic drugs such as Doxorubicin and Paclitaxel interfere with DNA replication or microtubule formation, blocking the cell cycle of cancer cells. Targeted therapy drugs specifically target certain molecular markers, such as Trastuzumab for HER2-positive breast cancer, which acts precisely on tumor cell surface receptors.
Regarding mechanisms, some drugs are cell cycle non-specific and effective against cancer cells in all phases of division; others are cycle-specific, targeting specific phases of cell division. Physicians choose single drugs or combination regimens based on tumor type and stage to enhance efficacy and reduce drug resistance.
Chemotherapy is applicable to various malignant tumors, including leukemia, lymphoma, breast cancer, lung cancer, colorectal cancer, and ovarian cancer. In hematologic cancers like Acute Myeloid Leukemia (AML), intensified chemotherapy regimens are often used. For solid tumors, chemotherapy can serve as neoadjuvant therapy to shrink tumors before surgery or as adjuvant therapy post-surgery to prevent recurrence.
In advanced cancer treatment, chemotherapy is often combined with targeted drugs or immunotherapy to improve overall efficacy. Additionally, for locally advanced tumors unsuitable for surgery, chemotherapy can serve as the primary treatment modality.
Administration methods include intravenous injection, oral medication, or intrathecal injection. Intravenous infusion is the most common route, allowing rapid achievement of blood drug concentrations; oral drugs are suitable for long-term maintenance therapy for some solid tumors. Dosages are calculated based on patient weight, liver and kidney function, and tumor burden, usually in cycles (cycles), administered weekly to monthly.
The length of treatment cycles varies depending on the condition; early-stage cancers may require 4-6 cycles, while advanced cases may continue for months. Physicians adjust dosages based on treatment response and side effects, with possible pauses or switching drugs if necessary.
Main advantages include:
Emerging targeted chemotherapy drugs can reduce damage to normal tissues, and high-dose therapy has significant efficacy in certain blood cancers such as multiple myeloma. Furthermore, chemotherapy can synergize with immunotherapy to enhance anti-tumor responses.
Common side effects include:
Serious risks include: cardiotoxicity (e.g., doxorubicin-induced myocardial damage), pulmonary toxicity (e.g., bleomycin-related interstitial pneumonia), and irreversible infertility. Some drugs may also increase the risk of secondary malignancies, requiring long-term follow-up.
Contraindications include severe bone marrow failure, uncontrolled hepatic or renal failure, and severe infections. Pregnant women receiving chemotherapy may cause fetal malformations and must strictly avoid pregnancy. Cardiac and pulmonary functions should be evaluated before treatment, such as checking left ventricular ejection fraction before anthracyclines.
During treatment, regular monitoring of hematologic and organ function is necessary. If fever, persistent vomiting, or respiratory difficulty occurs, medication should be stopped immediately. Special populations such as the elderly or those with chronic diseases require dosage adjustments and enhanced supportive care.
Combining chemotherapy with anticoagulants may increase bleeding risk, and NSAIDs may raise the risk of gastrointestinal ulcers. When used concurrently with radiotherapy in the same region, some chemotherapy drugs may exacerbate tissue damage.
When combined with immunotherapy drugs such as PD-1 inhibitors, attention should be paid to the cumulative effects of immune-related side effects. Physicians adjust dosing intervals based on drug metabolism, such as enzyme inducers potentially altering the half-life of chemotherapy drugs.
Clinical trials show that chemotherapy for Hodgkin's lymphoma can achieve complete remission rates of 70-90%, and combining targeted drugs can improve 5-year survival rates in breast cancer patients by 15-20%. In small cell lung cancer, concurrent chemoradiotherapy improves local control rates.
Systematic reviews indicate that newly diagnosed acute lymphoblastic leukemia patients receiving intensified chemotherapy, followed by bone marrow transplantation after complete remission, can achieve long-term survival rates exceeding 60%. However, for some solid tumors like pancreatic cancer, chemotherapy mainly delays progression rather than cures.
Targeted therapies based on specific gene mutations (e.g., EGFR inhibitors for lung cancer) or immune checkpoint inhibitors (e.g., PD-1/PD-L1 inhibitors) can serve as alternatives. Targeted drugs are more selective for specific molecular abnormalities, potentially reducing systemic toxicity.
The combination of targeted therapy and chemotherapy has become standard in non-small cell lung cancer and breast cancer. In some cases, photodynamic therapy or targeted radiotherapy can be used as local treatment options.
What is the difference between chemotherapy administered via intravenous injection and oral medication? How should treatment be coordinated?
Chemotherapy drugs can be administered via intravenous injection, oral, or subcutaneous routes. Intravenous injection is usually performed in hospitals, with the drug directly entering the bloodstream, providing rapid effect but possibly requiring brief hospitalization for observation; oral medications require strict adherence to schedule, and patients should pay attention to drug storage and dietary restrictions. It is important to confirm the specific method with the medical team before treatment and to arrange transportation and rest time, avoiding strenuous activities immediately after treatment.
What home remedies can help alleviate nausea and vomiting caused by chemotherapy, besides medication?
Doctors often prescribe antiemetics to prevent side effects, but patients can also relieve discomfort by sipping cold drinks, avoiding greasy foods, or inhaling peppermint oil. It is recommended to rest immediately after treatment, avoid eating immediately, and try bland foods after 1-2 hours. Keep track of symptom severity to adjust medication in future treatments.
What dietary principles should be followed during chemotherapy? Are there foods that might affect treatment efficacy?
During treatment, a high-protein, nutrient-dense diet is recommended, including quality proteins (fish, soy products), fresh vegetables, and fruits. Avoid raw or undercooked foods to prevent infection. Some herbs or high-dose vitamin C supplements may interfere with drug metabolism and should be discussed with a doctor beforehand. Daily water intake of 1500-2000 ml is advised to promote waste elimination.
What follow-up tests are needed after completing chemotherapy? How often should they be performed?
It is recommended to have blood tests and imaging every 3-6 months in the first year after treatment, then every 6-12 months depending on the condition. Follow-up items typically include tumor marker levels, organ function assessments, and signs of recurrence. For side effects like hair loss or nerve damage, ongoing monitoring of symptom improvement is necessary.
Do success rates of chemotherapy vary significantly among different cancers? How can individual treatment effectiveness be evaluated?
The success rate depends on cancer type, stage, and overall health; for example, complete remission rates for hematologic cancers can reach 70%, while advanced solid tumors are comparatively lower. Treatment effectiveness is assessed through imaging (e.g., CT scans) and tumor marker changes during treatment. Physicians classify responses as complete remission, partial remission, etc., based on tumor reduction or growth inhibition, and adjust subsequent plans accordingly.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
