Di Fiore Frédéric, Van Cutsem Eric
Digestive Oncology Unit, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Best Pract Res Clin Gastroenterol. 2009;23(1):113-24. doi: 10.1016/j.bpg.2008.11.016.
There are many anti-neoplastic agents in cancer treatment. Combination regimens are often the main standard treatment, particularly for gastrointestinal malignancies. The introduction of new regimens that combine fluoropyrimidines with irinotecan or oxaliplatin and recently also with antibodies against the Epidermal Growth Factor Receptor (EGFR) (cetuximab and panitumumab) and against the Vascular Endothelial Growth Factor (VEGF) (bevacizumab) pathways, has dramatically improved the progression free survival and survival of patients with metastatic colorectal cancer. This rapid extension of available anti-neoplastic drugs has, however, also highlighted the urgent need for clinicians to better understand and identify the spectrum of acute and late toxicities of these drugs. Acute and long-term adverse effects are inherent to non-surgical cancer treatment using chemotherapy and/or radiation therapy, which can profoundly affect the gastrointestinal tract leading to a wide spectrum of acute and late toxicities. An improved knowledge of the aetiology, incidence, supportive measures and of the prevention of these toxicities is warranted to improve patient care. We herein review and discuss the main acute and late gastrointestinal toxicities of chemotherapy and/or radiotherapy for patients with gastrointestinal malignancies.
癌症治疗中有许多抗肿瘤药物。联合治疗方案通常是主要的标准治疗方法，尤其是对于胃肠道恶性肿瘤。将氟嘧啶与伊立替康或奥沙利铂联合，以及最近还与抗表皮生长因子受体（EGFR）（西妥昔单抗和帕尼单抗）和抗血管内皮生长因子（VEGF）（贝伐单抗）途径的抗体联合的新方案，显著提高了转移性结直肠癌患者的无进展生存期和生存率。然而，可用抗肿瘤药物的这种迅速扩展也凸显了临床医生迫切需要更好地了解和识别这些药物的急性和晚期毒性谱。急性和长期不良反应是使用化疗和/或放疗的非手术癌症治疗所固有的，这会对胃肠道产生深远影响，导致广泛的急性和晚期毒性。有必要更好地了解这些毒性的病因、发生率、支持措施和预防方法，以改善患者护理。我们在此回顾并讨论胃肠道恶性肿瘤患者化疗和/或放疗的主要急性和晚期胃肠道毒性。
