Zusammenfassung
Seit den 1950er Jahren werden Zytostatika in der Tumortherapie eingesetzt. Über Anwendungsbeobachtungen und Dosisfindungsstudien mussten die tolerablen Dosierungen ermittelt werden. Auch heute verursachen viele Chemotherapieprotokolle noch erhebliche, teils lebensbedrohliche Nebenwirkungen. Übelkeit und Erbrechen gehören zu den häufigsten Beschwerden, weiterhin Mukositis, Müdigkeit und Schwäche. Die mögliche Knochenmarktoxizität führt zu erhöhter Infektionsneigung sowie gelegentlich zu Blutungen. Schäden an den Nieren, der Leber, dem Herzen, der Lunge, der Haut oder dem Nervensystem treten medikamentenabhängig auf. Da ein Großteil der Tumortherapien heute ambulant durchgeführt werden kann, kommt dem niedergelassenen Arzt eine wichtige Rolle in der Betreuung seiner Patienten mit den durch Zytostatika induzierten Nebenwirkungen zu.
Abstract
Cytotoxic drugs have been used in the therapy of malignant tumors for the last 70 years. However, side effects of cytotoxic drugs are very common and often dose-limiting. Although many protocols have been optimized, side effects are still frequently life-threatening. Nausea and vomiting are among the most frequently reported side effects, in addition to mucositis and fatigue. Bone marrow toxicity can lead to neutropenic sepsis, thrombocytopenic bleeding, or anemia with the respective sequelae. In addition to these unspecific side effects, organ toxicity is class or drug specific and may involve the kidney, liver, heart, lung, skin, or central nervous system. As most protocols can be administered on an outpatient basis, knowledge of these side effects is important for the general internist.
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Wollmer, E., Neubauer, A. Nebenwirkungen der medikamentösen Tumortherapie. Internist 52, 1429–1446 (2011). https://doi.org/10.1007/s00108-011-2930-4
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DOI: https://doi.org/10.1007/s00108-011-2930-4