Prophylaxe und Behandlung spezieller Nebenwirkungen von Zytostatika

  • B. Weiss
  • H.-P. Lipp
  • J. T. Hartmann
  • C. Bokemeyer
  • M. Sökler


Neben der allgemeinen, akut oder subchronisch auftretenden Toxizität auf gesundes, rasch proliferierendes Gewebe treten im Rahmen konventionell- und hochdosierter Chemotherapien — abhängig vom eingesetzten Zytostatikum — auch eine Reihe organspezifischer Toxizitäten auf. Diese lassen sich weniger durch die antiproliferative Aktivität, sondern vielmehr durch andere Eigenschaften des Zytostatikums wie der Entstehung bestimmter toxischer Metabolite oder durch relativ hohe Anreicherungen in einzelnen Organen erklären.


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Literatur zu 8.1

  1. Chertow GM, Sayegh MH, llgren RL, Lazarus JM (1996) Is the administration of dopamine associated with adverse or favorable outcomes in acute renal failure? Am J Med 101: 49–53PubMedCrossRefGoogle Scholar
  2. Kintzel PE, Dorr RT (1995) Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev 21: 33–64PubMedCrossRefGoogle Scholar
  3. Lipp H-P (1995) Prevention and management of anticancer drug toxicity — The significance of clinical pharmacokinetics. Univ.-Verlag, JenaGoogle Scholar
  4. Skinner R (1995) Strategies to prevent nephrotoxicity of anticancer drugs. Curr Opin Oncol 7: 310–315PubMedCrossRefGoogle Scholar
  5. Thadhani R, Pascual M, Bonventre JV (1996) Acute Renal Failure. N Engl J Med 30: 1448–1459CrossRefGoogle Scholar

Literatur zu 8.2

  1. Alberts DS, Noel JK (1995) Cisplatin-associated neurotoxicity: Can it be prevented? Anti-Cancer Drugs 6: 369PubMedCrossRefGoogle Scholar
  2. Anand AJ, Bashey B (1993) Newer insights into cisplatin nephrotoxicity. Ann Pharmacother 27: 1519–1525PubMedGoogle Scholar
  3. Bokemeyer C, Fels LM, Dunn T et al. (1996) Silibinin protects against cisplatin-induced nephrotoxicity without compromising cisplatin or ifosphamide anti-tumour activity. Br J Cancer 74: 2036–2041PubMedCrossRefGoogle Scholar
  4. Bokemeyer C, Hartmann JT, Kanz L (1997) Prävention cisplatininduzierter Chemotherapietoxizitäten durch Amifostin. Arzt Krankenh 2: 52–56Google Scholar
  5. McKeage MJ (1995) Comparative adverse effect profiles of platinum drugs. Drug Saf 13: 228–244PubMedCrossRefGoogle Scholar

Literatur zu 8.3

  1. Bedi A, Miller CB, Hanson JL et al. (1995) Association of BK virus with failure of prophylaxis against cystitis following bone marrow transplantation. J Clin Oncol 13: 1103–1109PubMedGoogle Scholar
  2. Dechant KL, Brogden RN, Pilkington T, Faulds D (1991) Ifosfamide/Mesna: A review of its antineoplastic activity, pharmacokinetic properties and therapeutic efficacy in cancer. Drugs 42: 428–467PubMedCrossRefGoogle Scholar
  3. Fleming RA, Cruz JM, Webb CD et al. (1996) Urinary elimination of cyclophosphamide alkylating metabolites and free thiols following two administration schedules of high-dose cyclophosphamide and mesna. Bone Marrow Transplant 17: 497–501PubMedGoogle Scholar
  4. Haselberger MB, Schwinghammer TL (1995) Efficacy of mesna for prevention of hemorrhagic cystitis after high-dose cyclophosphamide therapy. Ann Pharmacother 29: 918–921PubMedGoogle Scholar
  5. Katz A, Epelman S, Anelli A et al. (1995) A prospective randomized evaluation of three schedules of mesna administration in patients receiving an ifosfamide-containing chemotherapy regimen: sustained efficiency and simplified administration. J Cancer Res Clin Oncol 121: 128–131PubMedCrossRefGoogle Scholar
  6. Kurowski V, Wagner T (1997) Urinary excretion of ifosfamide, 4-hydroxyifosfamide, 3- and 2-dechloro-ethylifosfamide, mesna, and dimesna in patients on fractionated intravenous ifosfamide and concomitant mesna therapy. Cancer Chemother Pharmacol 39: 431–439PubMedCrossRefGoogle Scholar
  7. Lauterburg BH, Nguyen T, Hartmann B et al. (1994) Depletion of total cysteine, glutathione, and homocysteine in plasma by ifofamide/mesna therapy. Cancer Chemother Pharmacol 35: 132–136PubMedCrossRefGoogle Scholar

Literatur zu 8.4

  1. Borsi JD, Sagen ES, Romslo I, Moe PJ (1990) Rescue after intermediate and high-dose Methotrexate. Ped Hematol Oncol 7: 347–363CrossRefGoogle Scholar
  2. Comelia P, Palmieri G, Beneduce G et al. (1996) Significance of methotrexate serum level achieved in patients with gastroinstestinal malignancies treated with sequential methotrexate, L-Folinic Acid and 5-Fluorouracil. Oncology 53: 198–203CrossRefGoogle Scholar
  3. Gögbuget N, Hoelzer D (1996) High-dose methotrexate in the treatment of adult acute lymphoblastic leukemia. Ann Hematol 72: 194–201CrossRefGoogle Scholar
  4. Relling MV, Stapleton F, Ochs J et al. (1988) Removal of methotrexate, leucovorin and their metabolites by combined hemodialysis and hemoperfusion. Cancer 62: 884–888PubMedCrossRefGoogle Scholar
  5. Relling MV, Fairclough D, Ayers D et al. (1994) Patient characteristics associated with high-risk methotrexate concentrations and toxicity. J Clin Oncol 12: 1667–72PubMedGoogle Scholar
  6. Teresi ME, Rodman JH (1993) Methotrexate; in: Clinical phamacokinetics pocket reference; J.E. Murphy (ed), 157–177. American Society of Hospital PharmacistsGoogle Scholar
  7. Thomson AH, Daly M, Knepil J, Harden P, Symonds P (1996) Methotrexate removal during haemodi-alysis in a patient with advanced laryngeal carcinoma. Cancer Chemother Pharmacol 38: 566–570PubMedCrossRefGoogle Scholar
  8. Treon SP, Chabner BA (1996) Concepts in use of high-dose methotrexate therapy. Clin Chem 42: 1322–1329PubMedGoogle Scholar

Literatur zu 8.5

  1. Bizzari JP, Le Bail N (1994) Docetaxel: RP 56976. Integrated safety summary, updated analysis. Rhone-Poulenc Rorer, 25 October 1994Google Scholar
  2. Boehm DK (1996) Paclitaxel. Premedication regimens. J Natl Cancer Inst 88: 463–465PubMedCrossRefGoogle Scholar
  3. Bristol-Meyers Squibb (1993) Paclitaxel administration guide. Princeton/NJGoogle Scholar
  4. Chan S, Winterbottom L, Gardner S (1996) Response to dexamethasone in patients with fluid retention after docetaxel. Lancet 347: 1486–1487PubMedCrossRefGoogle Scholar
  5. Gennari A, Salvadori B, Tognoni A, Conte PF (1996) Rapid intravenous premedication with dexamethasone prevents hypersensitivity reactions to paclitaxel. Ann Oncol 7: 978–979PubMedGoogle Scholar
  6. Parikh B, Khanolkar S, Advani SH (1996) Safety profile of single-dose dexamethasone premedication for paclitaxel. J Clin Oncol 14: 2189–2190PubMedGoogle Scholar
  7. Piccard MJ, Klijn J, Paridaens R et al. (1997) Corticosteroids significantly delay the onset of docetaxel-induced fluid-retention: Final results of a randomized study of the european organization for research and treatment of cancer investigational drug branch for breast cancer. J Clin Oncol 15: 3149–3155Google Scholar
  8. Riva A, Fumoleau P, Roché H et al. (1997) Efficacy and safety of different corticosteroid (C) premedications (P) in breast cancer (BC) patients (Pts) treated with Taxotere (T). Proc Am Soc Clin Oncol 16: 188 aGoogle Scholar
  9. Weiss RB, Donehower RC, Wienik PH et al. (1990) Hypersensitivity reactions from paclitaxel. J Clin Oncol 8: 1263–1268PubMedGoogle Scholar

Literatur zu 8.6

  1. Alberts DS, Bleyer WA (1996) Future development of amifostine in cancer treatment. Semin Oncol 23 Suppl 8: 90–99Google Scholar
  2. Bokemeyer C, Hartmann JT, Fels L et al. (1997) Amifostine protects against early cisplatin-induced renal damage and enhances CD 34+ cell numbers for PBSC collection. Proc Am Soc Clin Oncol 16: 47 a/166 (Abstr)Google Scholar
  3. Bokemeyer C, Hartmann JT, Kanz L (1997) Prävention cisplatininduzierter Chemotherapietoxizitäten durch Amifostin. Arzt Krankenh 2: 52–56Google Scholar
  4. Capizzi RL, Oster W (1995) Protection of normal tissue from the cytotoxic effects of chemotherapy and radiation by amifostine: clinical experiences. Eur J Cancer 31 A (Suppl 1): 8–13CrossRefGoogle Scholar
  5. Dorr RT (1996) Cytoprotective agents for anthracyclines. Semin Oncol 23 (Suppl 8): 23–34PubMedGoogle Scholar
  6. Gerritsen-Van der Hoop R, Hamers FP, Neijt JP, Veldman H, Gispen WH, Jennekens FG (1994) Protection against cisplatin induced neurotoxicity by ORG 2766: histological and electrophysiological evidence. J Neurol Sci 126: 109–115PubMedCrossRefGoogle Scholar
  7. Hamers FP, Pette C, Neijt JP, Gispen WH (1993) The ACTH-(4–9) analog, ORG 2766 prevents taxol-induced neuropathy in rats. Eur J Pharmacol 233: 177–178PubMedCrossRefGoogle Scholar
  8. Hellmann K (1996) Anthracycline cardiotoxicity prevention by dexrazoxane: breakthrough of a barrier-sharpens antitumor profile and therapeutic index. J Clin Oncol 14: 332–333PubMedGoogle Scholar
  9. Highley MS, Momerency G, van Cuwenberghe K (1995) Formation of chloroethylamine and 1,3-oxazolidine-2-one following ifosfamide. administration in humans. Drug Metab Dispos 23: 433–437PubMedGoogle Scholar
  10. Hochster H, Wasserheit C, Speyer J (1995) Cardiotoxicity and cardioprotection during chemotherapy. Curr Opin Oncol 7: 304–309PubMedCrossRefGoogle Scholar
  11. Imondi AR, Delia-Torre P, Mazue G et al. (1996) Dose-response relationship of dexrazoxane for prevention of doxorubicin-induced cardiotoxicity in mice, rats, and dogs. Cancer Res 56: 4200–4204PubMedGoogle Scholar
  12. Kemp G, Rose P,Lurain J et al. (1996) Amifostine pretreatment for protection against cyclophosphamide-induced and cisplatin-induced toxicities: results of a randomized control trial in patients with advanced ovarian cancer. J Clin Oncol 14: 2101–2112PubMedGoogle Scholar
  13. Küpfer A, Aeschlimann C, Cerny C (1996) Methylenblue and the neurotoxic mechanism of ifosfamide encephalopathy. Eur J Clin Pharmacol zz: 249–252Google Scholar
  14. Schiller JH, Storer B, Berlin J et al. (1996) Amifostine, cisplatin, and vinblastine in metastatic non-small-cell lung cancer: a report of high response rates and prolonged survival J ClinOncol 14: 1913–1921Google Scholar
  15. Shan K, Lincoff AM, Young JB (1996) Anthracycline-induced cardiotoxicity. Ann Intern Med 125: 47–58PubMedGoogle Scholar
  16. Swain SM, Whaley FS, Gerber MC, Ewer MS, Bianchine JR, Gams RA (1997) Delayed administration of dexrazoxane provides cardioprotection for patients with advanced breast cancer treated with doxorubicin-containing therapy. J Clin Oncol 15: 1333–1340PubMedGoogle Scholar
  17. Swain SM, Whaley FS, Gerber MC et al. (1997) Cardioprotection with dexrazoxane for doxorubicin-containing therapy in advanced breast cancer. J Clin Oncol 15: 1318–1332PubMedGoogle Scholar
  18. Tannehill SP,Mehta MP (1996) Amifostine and radiation therapy: past, present, and future. Semin Oncol 23: Suppl 8: 69–77PubMedGoogle Scholar
  19. Van Kooten B, Van Diemen HA, Groenhout KM et al. (1992) A pilot study on the influence of a corticotropin (4–9) analogue on vinca alkaloid-induced neuropathy. Arch Neurol 49: 1027–1031PubMedGoogle Scholar
  20. Venturini M, Michelotti A, Del Mastro L et al. (1996) Multicenter randomized controlled clinical trial to evaluate cardioprotection of dexrazoxane vs. no cardioprotection in women receiving epirubicin chemotherapy for advanced breast cancer. J Clin Oncol 14: 3112–3120PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • B. Weiss
  • H.-P. Lipp
  • J. T. Hartmann
  • C. Bokemeyer
  • M. Sökler

There are no affiliations available

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