Other Modes of Treatment Pierette Y. Kaw, MD, FPCS Department of Surgery The Medical City.
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Transcript of Other Modes of Treatment Pierette Y. Kaw, MD, FPCS Department of Surgery The Medical City.
![Page 1: Other Modes of Treatment Pierette Y. Kaw, MD, FPCS Department of Surgery The Medical City.](https://reader035.fdocuments.net/reader035/viewer/2022081503/56649f315503460f94c4cfcc/html5/thumbnails/1.jpg)
Other Modes of Treatment
Pierette Y. Kaw, MD, FPCSDepartment of Surgery
The Medical City
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Treatment Options
SurgeryChemotherapyHormonal Therapy ImmunotherapyGene TherapyRadiation Therapy
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Chemotherapy
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First order kineticsCell-cycle phase specificCell-cycle phase non-specific
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Chemotherapeutic Drugs Alkylating agents classic nitrosoureas miscellaneous DNA-binding agents Antitumor antibiotics Antimetabolites folate/purine/pyrimidine analogues ribonucleotide reductase inhibitors Plant alkaloids miscellaneous
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Chemotherapy
ADJUVANT postoperative
preoperative/induction/neoadjuvant
PRIMARY
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Preoperative/Induction/Neoadjuvant Advantages decrease tumor burden/size treatment without delay of postop recovery assess tumor’s response clinically &
pathologically Disadvantages patient selection problems w tumor localization, margin
analysis, pathologic staging *rates of infection, necrosis-no significant
difference
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Combination chemotherapy Drug Resistance genetically unstable tumor cells large tumor size
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Drug Toxicity
bone marrow suppressionstomatitisulceration of GITalopecia
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Hormonal Therapy
Estrogen receptorProgesterone receptor
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Immunotherapy
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Gene Therapy
Replacement or deletion of tumor suppressor genes to enhance immune response to cancer cells
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Radiation Therapy
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Adjuvant (Preoperative)
Advantages minimize seeding make inoperable operable Disadvantages wound healing problems subsequent RT in positive
margins?
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Postoperative
Advantages proper histologic evaluation RT modified on the basis of margin status Disadvantages larger radiation dose due to
contamination less radiosensitive due to hypoxia postop adhesions exposes more bowel to
radiation
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RT
chemo be given before or concurrently w radiation
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Side Effects
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Cancer Prevention
Primary Secondary Tertiary* chemoprevention
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Thank you