Possible acceleration of aging by adjuvant chemotherapy: a cause of early onset frailty?

摘要: Cancer chemotherapy has three main applications. It is curative for a small number of malignancies including childhood leukemia, Hodgkin's and non-Hodgkin's lymphoma, germ cell malignancies. palliative role most metastatic epithelial Finally, it an adjuvant in several types resected particularly breast cancer. First successfully employed the mid 1970s, associated with up to 30% relative improvement long-term overall survival high risk cancer but demonstrates significantly less absolute improvement. Now that being used lower disease, both even impressive. With growing survivors, we are only now able define delayed implications chemotherapy. These side effects include acceleration neurocognitive decline, musculoskeletal complications such as early onset osteoporosis, premature skin ocular changes common complaint; mild profound fatigue. This complex problems suggestive frailty. paper explores various potential mechanisms aging accumulation free-radical damage, DNA telomere shortening accompanying decline telomerase activity finally neuroendocrine/immune function. The impact chemotherapy, those agents setting, relationship these explored. There good evidence can effect all leading this hypothesis quite profound. Whereas short-term toxicity usually be considered acceptable survival, frailty have on quality life could last years. possible decision take chemo, what use, means minimize need monitor