[Cytostatic drugs--mechanism of action and guidelines for clinical use]

The indication spectrum for the hospital and office use of cytostatic agents is continuing to expand. For such treatment to be successful, a basic knowledge of the mode of action of various cytostatic drugs, and appropriate experience with the application guidelines and side effects are necessary. The various classes of cytostatic drugs are briefly characterized, and attention is drawn to new developments (new substances, overcoming of resistance, growth factors, cytokines). Since adverse reactions can affect not only the patients receiving treatment, but also medical staff handling such medicaments, particular attention must be directed to providing protective measures at the workplace. The specific toxicities of some cytostatic agents are mentioned. Supportive measures required after accidental mis-use (e.g. injection of intravenous drugs into paravascular tissue, overdosage) are described. For some cytostatic drugs there are dose and application restrictions that depend upon disordered organ function--renal, hepatic, cardiac, bone marrow. Employed by experienced doctors in accordance with all the "rules" of application, cytostatic therapy is a safe form of therapy which, in addition to its palliative character, is increasingly showing a curative tendency (e.g. childhood malignancies, malignant diseases of the lymphatic system testicular tumors, adjuvant chemotherapy for certain indications).