Management Outcomes and Preventive Stratigies of Gastrointestinal Lesions in Patients Receiving Chemotherapy for Breast Cancer

Abstract

Chemotherapy in modern oncology, along with surgical methods and radiotherapy, is one of the most important components of the treatment of patients with malignant neoplasms. At the same time, long-term treatment, a large number of complications and, as a consequence, deterioration in the quality of life of such patients with loss of ability to work and the possibility of death put the problem of prevention and treatment of toxic reactions in patients receiving chemotherapy in a number of socially significant problems. The most sensitive to the destructive action of chemotherapy drugs are rapid division and growing tissues of the body, which include the epithelium of the gastrointestinal tract (GIT). The incidence of gastrointestinal toxicity in patients receiving chemotherapy ranges from 4.7% to 69.2% due to both the direct damaging effect of toxic effect on epithelial cells and infection. Data on the incidence of hepatotoxicity during chemotherapy vary from 14.3 to 100%, which may be due to different mechanisms of action of cytotoxic agents, including their damaging effect on the liver. Untimely correction of complications from the digestive system may require discontinuation of special treatment, change of the scheme of obviously effective therapy, which significantly worsens the therapeutic effect of chemotherapy, and consequently the prognosis of the disease. In addition, there is a decrease in the quality of life of patients, there is a need for additional examination and treatment. This work aimed to improve the quality of life and safety of treatment of breast cancer patients receiving chemotherapy. The main objectives were identifying the patients at risk of GI and liver complications with an emphasis on the influence of cancer stage, patient age, and preexisting medical conditions and suggesting recommendations for follow-up examination and prophylactic treatments according to the degree of liver and mucosal damage both before and after chemotherapy.