HE440 Lecture Notes - Lecture 20: Methotrexate, External Beam Radiotherapy, Sorafenib

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22 Feb 2021
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Cancer treatment: surgical removal, minimally invasive techniques, improved anesthesia, limited by health of patient and site of tumour, degree of invasion, additional/adjuvant treatment, radiotherapy, chemotherapy. Radiotherapy: dose of radiation: maximize killing effect for tumour while sparing normal tissue (therapeutic index, newer advances: image guided, intensity modulation, proton beam therapy: targeted to tumour, external beam radiotherapy, molecular radiotherapy, radionuclides into the body, targeted, brachytherapy. Chemotherapy: often administered with surgery and radiotherapy, can target dividing cells (cytotoxins, side effects, no effects on other areas of tumour progression. Chemotherapy: example: methotrexate, antimetabolite, folic acid analogue. Inhibits nucleic acid synthesis: dihydrofolate reductase dhfr (purine and pyrimidine synthesis) Chemotherapy: example: cisplatin, platinum compound, forms dna adducts, prevents cell division, particularly effective against testicular cancer. Targeting proliferation pathways: not just generally cytotoxic, targeted or precision therapies -> act on specific molecules, can be cytostatic -> block progression rather than killing.

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