Cytostatic therapy is a therapeutic procedure in oncology (science dealing with cancer) that can be used primarily to treat malignant neoplasms (malignant neoplasms, cancer). Malignant (malignant) cells, in addition to the characteristic of increased proliferation (growth), also possess other characteristics for increased survival of tumor cells. These characteristics include decreased apoptosis (form of programmed cell death), loss of tumor-suppressing proteins (tumor-suppressing proteins/proteins), genomic instability (instability of the genetic material), and generalized immortalization (immortality).
Therapeutic Target
The use of cytostatic drugs (synonym: chemotherapeutic drugs) can destroy a constant fraction of tumor cells (proportion of tumor cells). The function of cytostatic drugs is primarily based on inhibiting the progress of tumor cells in the cell cycle. Depending on the cytostatic drug, specific vulnerable phases (phases of action in which the malignant cells are vulnerable) exist in the cell cycle. Since tumor cells have an increased cell division rate compared to physiologically occurring somatic cells (non-tumor cells) and a reduced repair capacity, they are more sensitive to cytostatic drugs than healthy cells and are relatively selectively destroyed or inhibited (inhibited in growth). Because of this difference, therapy with usually highly toxic substances is possible.
The primary therapeutic goal depends on the present clinical picture and the cytostatic drug used. Chemotherapy can be administered neoadjuvantly (= neoadjuvant chemotherapy, NACT), so that a reduction in tumor mass can be achieved through the use of cytostatic drugs prior to surgical intervention. In this case, chemotherapy makes a tumor that is initially inoperable or only partially operable accessible to surgical therapy. In adjuvant chemotherapy, metastasis (formation of daughter tumors) or micrometastasis (as yet undetectable tumor metastases) is combated after complete surgical removal of the tumor in order to improve the chances of cure, quality of life or life expectancy.
In addition, there is palliative chemotherapy, which is intended to improve the patient’s quality of life and prolong life in the last months of life. A prospective study was able to demonstrate that these goals are not achieved.
The dosage of cytostatic drugs is often based on the patient’s body surface area (mg/m²).
The following groups of agents are used in cytostatic therapy:
- Alkylanzien
- Anthracyclines
- Antimetabolites
- Platinum derivatives
- Taxanes
- Topoisomerase inhibitors
- Vinca alkaloids
Further information on dosage and specifics of the drug groups and active ingredients below.
Further notes
- The risk that cytostatic therapy in the second or third trimester (third trimester) of pregnancy will harm the baby is probably low.
- Chemotherapy can lead to mild cognitive impairment, but probably in the sense of “chemobrain” but as a result of posttraumatic stress (PTS). However, some patients showed slightly longer reaction times after chemotherapy in a computer-based test in which they had to click as soon as a cross appeared on the screen. This could have resulted from peripheral neuropathy of the finger nerves due to certain cytostatic drugs, and have nothing to do with cognitive function.
