Adverse Reactions Of The Anticancer Drugs

Objective:At present the major methods of the cancer therapy are operation,radiotherapy,chemotherapy and biotherapy.Chemotherapy has become one of the effective methods to treat the cancer,which is using chemical drugs.These drugs can rapidly distribute to all over the body,so chemotherapy not only can kill the local tumor,but also can kill the metastatic tumor and treat the primary tumor,metastasis and Asia Clinical metastasis.The effect of chemotherapy depends on the type and condition of the tumor.Chemotherapy can inhibit tumor growth and diffusion,it is the only therapic method to certain tumors.With the rapid development of chemotherapy drugs and the progress of chemotherapy ways,the chemotherapy has attracted more and more people's attention,but the adverse reactions of chemotherapic drugs often limit its wider application.The purpose of this article is to obtain the knowledge of genetic extent,the mechanism and the relevant factors of adverse reactions through the investigation and analysis of the pathological data of the cancer patients.The results will provide a greatly advantaged basis for better application of anticancer drugs in clinic and improvement in the quality of cancer patients' life.Methods:We select the hospital records of 306 cases of patients with malignant tumors from Shandong Provincial Hospital from July 2007 to May 2008.Record and analyzed the adverse reactions caused by chemotherapy,and age,sex,chemotherapic proposal, chemotherapy drugs,preventive medication,immune regulation medicines,traditional Chinese medicine etc.The definition of adverse reactions adopt the relevant provisions of the "adverse drug reaction reporting and monitoring management approach" jointly promulgated by the State Food and Drug Administration and the Ministry of Health.The adverse reactions classified by the WHO standards.The regularity of adverse reactions, drug characteristics,various influencing factors are summarized from the relevant factors of the adverse reaction by statistical analysis in the survey summary table.According to the results of the statistics analysis,we propose the prevention and treatment measures of the adverse reactions caused by the anticancer drugs.Results:Among the 306 patients with cancer investigated in the case(165 male and 141 female),there are 3 ones younger than 20 years old,6 ones from20 to 29 years old,12 ones from 30 to 39 years old,42 ones from 40 to 49 years old,111 ones from 50 to 59 years old,87 ones from 60 to 69 years old,33 ones from 70 to 79 years old,12 ones over 80 years old.In the cases,the breast cancer is 17.6%,the lung cancer is 16.70%,the gastric cancer is 13.70%,the ovarian cancer is 7.80%,the esophageal cancer is 7%,the rectal cancer is 6%,and the remaining cancers(nasopharyngeal cancer,endometrial cancer,bladder cancer,lymphoma,pelvic cancer,prostate cancer,etc) are 31.20%.Our investigation involves 21 kinds of cancer,65 types of anticancer drugs,51 types of Chemotherapy plans, and 1167 times of chemotherapy.The incidence rate of the adverse reaction of every system is:85.3%for the digestive tract,34.7%for blood system,10.7%for cardiac toxicity,6.1%for urinary system,9.8% for the neurotoxicity,4.6%for phlebitis,3.0%for allergic reaction.Nausea,vomiting and the bone marrow suppression have the highest incidence,which are the most important syndromes in the process of cancer chemotherapy in patients.The drug's descending order according to the incidence rate of the nausea and vomiting that chemotherapy drugs caused is:diamminedichloroplatinum(DDP),5-fluorouracil(5-FU),etoposide(VP-16), cyclophosphamide(CTX),adriamycin(ADM),carboplatin(CBP).Diammine dichloroplatinum(DDP) have a highest frequency,whose incidence rate is 100%.The drug's descending order by the incidence rate of the diarrhea and mouth ulcers that chemotherapy drugs caused is:paclitaxel(PTX),gemcitabine(CEM),adriamycin(ADM). The drug's descending order by the incidence rate of the bone marrow suppression that chemotherapy drugs caused is:paclitaxe(PTX),adriamycin(ADM),Vinorelbine(VLB), cyclophosphamide(CTX),mitomycin(MMC).The chemotherapy drugs that could bring about the cardiac toxicity are Epirubicin(EPI),adriamycin(ADM) and cyclophosphamide (CTX).The chemotherapy drugs that could arise the nephrotoxicity are diamminedichloroplatinum(DDP),mitomycin(MMC),ifosfamide(IFO).Moreover we have found that the prevention medication has played a very important role in releasing vomit,increacing the number of WBC,liver protection,enhancing immunity,reducing nephrotoxicity,antianaphylaxis,speeding up the elimination of the drugs.Thus it greatly reduces the incidence rate of the adverse reaction.The prophylactic drugs that frequently used are antiemetic,hepatic protectant,energy mixture,cardiac protectant,nutriceutical,diuretics,catharsis drugs,immunization drugs,antibiotics, etc.These drugs should be used in the course of chemotherapy according to the response of patients.Conclusions:1.Because of the high incidence rate of the adverse reaction and side effects of the anticancer drugs,chemotherapy must be standardized,mustn't reduce the dose or terminate or extended the times of chemotherapy in the course of effective treatment.It would better perform individual administration to get the greatest curative effect and reduce side effect as far as possible.2.It is the gastrointestinal toxicity and bone marrow suppression that have the highest incidence rate and the greatest impact on the body of the patients during the adverse reaction caused by the anticancer drugs.All anticancer drugs can cause certain nausea and vomiting,blood cells reduction.The neurotoxicity,hepatotoxicity,cardiotoxic toxicity, nephrotoxicity,anaphylactic response of anticancer drug are closely correlated with chemotherapy plans.The chemotherapy plans are closely related to the side effects of chemotherapy drugs,drug compatibility of drugs,drug combination,individual differences. The utilization rate of the platinum drug reached 60%-72%in all treatment programmes, the main of which is the cisplatin and oxaliplatin.And the main toxicity of the platinum drug is serious nausea and vomiting,nephrotoxicity,neurotoxicity and bone marrow suppression.In addition,5-FU,GEM,PTX and their analogues also have a large proportion in the programme of chemotherapy. 3.The elder patient is,the higher incidence rate of adverse reaction is before the age of 70.Sex has little effect on the incidence rate of adverse reaction.4.The infection easily takes place in the treatment course of the cancer,its main measure of the treatment is extenuation or deactivating chemotherapy drugs,symptomatic treatment,application of the antibiotics and immunostimulants.5.Because of the low effciency of a single drug used cancer,so a single chemotherapy plan obviously less than combined chemotherapy,whose plan often use combined drugs having nonoverlaping toxicity and consider order and course of the administration.6.The factors influencing the adverse reaction of the anticancer drugs are:①the character of the drugs;②the style of the administration③the rate of infection,the higher rate of infection and the higher incidence rate of the adverse reaction;④the stage of the tumor,the more deeply invasive tumors and the more lymphatic metastasis,the higher incidence;⑤individual factors,individual physical and psychological quality is worse,the incidence rate of the adverse reaction is higher;⑥drug combination,the traditional Chinese medicine and immunization preparation can low the incidence rate of ADR.;⑦the other factors,such as nursing factors,environmental factors,cultural diathesis factors have also played a part in influencing ADR.Therefore,individual administration is necessary to achieve the greatest therapeutic effect and reduce the incidence rate of the adverse reaction.