This article introduces the systemic and local adverse reactions, prevention and treatment of anti-tumor drugs.

Anti-tumor drugs have varying degrees of toxicity. While killing cancer cells, normal tissue cells are also fatally damaged, causing adverse reactions of varying severity. Through the clever combination of anti-tumor drugs and their auxiliary drugs and the careful use of preventive drugs, the occurrence of adverse reactions of anti-tumor drugs can be effectively reduced, patient compliance can be increased, and the dignity of patients' lives can be ensured.

1. Classification of commonly used anti-tumor drugs

2. Common adverse reactions of anti-tumor drugs

While chemotherapy drugs kill tumors, they also cause varying degrees of damage to tissues and organs throughout the body, especially the actively proliferating bone marrow, gastrointestinal mucosa, germ cells, hair, liver, kidneys and other organs, affecting the quality of life and even life. .

Clinically, adverse reactions caused by anti-tumor drugs are divided into:

1. Immediate reaction: local irritation, nausea, vomiting, fever, allergic reaction;

2. Recent reactions: bone marrow suppression, alopecia, stomatitis, diarrhea, organ function damage;

3. Long-term reactions: induction of tumors, suppression of immune function, infertility, etc.

Recent toxic reactions generally refer to toxic reactions that occur within 4 weeks after administration. The manifestations can be divided into: systemic reactions and local reactions.

3. Systemic reactions and prevention of anti-tumor drugs

According to U.S. statistics, the mortality rate caused by chemotherapy side effects and complications is 3% to 10%. Some patients refuse effective chemotherapy because they cannot tolerate the adverse effects of antitumor drugs. Therefore, we should pay attention to the adverse reactions of anti-tumor drugs, focus on prevention, and use reasonable combination.

1. Digestive system reaction: 5-HT3 receptor antagonists (granisetron, ondansetron, tropisetron, etc.) are used to prevent and treat nausea and vomiting caused by anti-tumor drugs.

2. Hematopoietic system reaction: Methotrexate combined with leucovorin can help patients tolerate high doses of methotrexate, thereby reducing mucosal damage and bone marrow suppression caused by methotrexate, while killing more tumor cells and improve the chemical efficiency index. The application of fluorouracil needs to be synergized with calcium leucovorin, especially in the treatment of colorectal cancer, which is better than fluorouracil monotherapy.

3. Urinary system toxicity: Mesna can prevent the occurrence of urinary tract toxicity. It is used as a routine treatment when using ifosfamide, and is also used in patients using high-dose cyclophosphamide. Amifostine is used to reduce cisplatin-induced nephrotoxicity.

4. Hepatotoxicity: Antioxidants such as tiopronin and reduced glutathione, and endogenous protective factors such as adenosylmethionine, coenzyme A, adenosine triphosphate, and inosine are used to treat drug-induced liver damage during chemotherapy.

5. Cardiotoxicity: Dextroximine is an inhibitor of eukaryotic DNA topoisomerase II and has been proven to be effective in preventing cardiotoxicity caused by anthracyclines.

6. Pulmonary toxicity: Glucocorticoids can effectively improve the pulmonary toxic reactions caused by bleomycin treatment.

7. Nervous system toxicity: Vitamins B1, B12 and other neurotrophic drugs can be used for nervous system damage caused by 5-FU and vincristine.

8. Anaphylaxis (allergic reactions are divided into local and systemic): Symptoms or signs that appear within 15 minutes after taking the drug should be regarded as systemic allergic reactions, which can manifest as facial redness, urticaria, hypotension, cyanosis, etc. Currently, paclitaxel is an important drug that causes allergic reactions in clinical practice and has the characteristics of immediate allergic reactions. Commonly used preventive drugs are: dexamethasone or prednisone, chlorpheniramine maleate, ranitidine, etc.

4. Local reactions and prevention of anti-tumor drugs

The local reactions of anti-tumor drugs are mainly skin toxic reactions caused by drug extravasation, embolic phlebitis and hand-foot syndrome, which are related to the tissue irritation of some anti-tumor drugs.

1. Extravasation of medicinal solution: It can cause pain, swelling and local tissue necrosis, or form local induration, fibrotic contracture and ulcers. Extravasation of anti-tumor drugs should be treated promptly and an antidote should be used (see table below).

2. Embolic phlebitis: It can cause pigmentation and is a common adverse reaction of 5-FU and anthracyclines. Prevention and treatment drugs include magnesium sulfate, nitroglycerin, heparin gel, etc.

3. Hand-foot syndrome: This is a common adverse reaction of capecitabine. The main clinical manifestations are finger (toe) heat, pain, and erythematous swelling. In severe cases, it may progress to desquamation, ulcers, and severe pain. Oral large-dose VitB6 () and 20% urea cream moisturizing are used for prevention and treatment.

Chemotherapy of tumors is of great significance to the comprehensive treatment of tumors. How to use anti-tumor drugs effectively, rationally and economically, rationally allocate drug resources, enhance the effect of chemotherapy, and improve the quality of life of tumor patients are key issues in tumor treatment. The most important question.