Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.
Curr Med Chem. 2009;16(25):3267-85. doi: 10.2174/092986709788803312. Epub 2009 Sep 1.
The anthracycline doxorubicin (DOX) is widely used in chemotherapy due to its efficacy in fighting a wide range of cancers such as carcinomas, sarcomas and hematological cancers. Despite extensive clinical utilization, the mechanisms of action of DOX remain under intense debate. A growing body of evidence supports the view that this drug can be a double-edge sword. Indeed, injury to nontargeted tissues often complicates cancer treatment by limiting therapeutic dosages of DOX and diminishing the quality of patients' life during and after DOX treatment. The literature shows that the heart is a preferential target of DOX toxicity. However, this anticancer drug also affects other organs like the brain, kidney and liver. This review is mainly devoted to discuss the mechanisms underlying not only DOX beneficial effects but also its toxic outcomes. Additionally, clinical studies focusing the therapeutic efficacy and side effects of DOX treatment will be discussed. Finally, some potential strategies to attenuate DOX-induced toxicity will be debated.
阿霉素（DOX）是一种广泛应用于化疗的蒽环类抗生素，由于其在治疗多种癌症（如癌、肉瘤和血液系统癌症）方面的疗效而备受关注。尽管临床应用广泛，但 DOX 的作用机制仍存在激烈争议。越来越多的证据支持这样一种观点，即这种药物可能是一把双刃剑。事实上，对非靶向组织的损伤常常通过限制 DOX 的治疗剂量以及降低患者在 DOX 治疗期间和之后的生活质量来使癌症治疗复杂化。文献表明，心脏是 DOX 毒性的首选靶器官。然而，这种抗癌药物也会影响其他器官，如脑、肾和肝。本综述主要致力于讨论 DOX 不仅具有有益作用，而且具有毒性作用的机制。此外，还将讨论侧重于 DOX 治疗的疗效和副作用的临床研究。最后，将讨论一些减轻 DOX 诱导的毒性的潜在策略。
