Clinical implications of chemotherapeutic agent organ toxicity on perioperative care

Biomed Pharmacother. 2022 Feb:146:112503. doi: 10.1016/j.biopha.2021.112503. Epub 2021 Dec 15.

Abstract

Cancer is the second most common cause of death in the United States and is a challenging disease to treat. The treatment options for various cancers include but are not limited to surgery, radiation, and chemotherapy. The mechanism behind chemotherapy is intended to promote cellular damage to cells that are proliferating uncontrollably. Unfortunately for the recipients, most chemotherapeutic agents cannot differentiate between malignant cells and healthy cells and tissues. Thus, chemotherapy-induced toxicities are often observed in once-healthy organs. These effects can be acute and self-limiting or chronic, appearing long after chemotherapy is completed. Cancer survivors can then present for non-cancer related surgeries later in life, due to this toxicity. Furthermore, the administration of chemotherapeutic agents can profoundly impact the anesthetic management of patients who are undergoing surgery. This review discusses how chemotherapy-induced organ toxicity can occur in multiple organ systems and what drugs should be avoided if prior toxicity exists in these organ systems.

Keywords: Anesthesia; Cancer; Chemotherapy; Perioperative; Toxicity.

Publication types

  • Review

MeSH terms

  • Anesthesia / methods
  • Anesthetics / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Clinical Protocols
  • Humans
  • Multiple Organ Failure / chemically induced*
  • Multiple Organ Failure / pathology*
  • Multiple Organ Failure / prevention & control
  • Neoplasms / drug therapy*
  • Pain, Postoperative / drug therapy
  • Perioperative Care / methods*
  • Surgical Procedures, Operative / methods

Substances

  • Anesthetics
  • Antineoplastic Agents