Neoadjuvant chemotherapy and perioperative cardiotoxicity.
Yingzhou Tu1, Suli Zhou1, Haoran Wang1
1Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Journal of Anesthesia and Translational Medicine
|April 3, 2026
Summary
Neoadjuvant chemotherapy can cause heart problems in cancer patients. Protecting heart function during surgery is crucial for better outcomes.
Area of Science:
- Oncology
- Cardiology
- Anesthesiology
Background:
- Malignant tumors are a significant global health challenge.
- Neoadjuvant chemotherapy is a common pre-surgical treatment for many cancers.
- This therapy can cause significant cardiotoxicity, including heart failure.
Purpose of the Study:
- To review neoadjuvant chemotherapy protocols.
- To discuss mechanisms of chemotherapy-induced cardiotoxicity.
- To highlight the importance of perioperative cardiac protection in cancer surgery.
Main Methods:
- Literature review of neoadjuvant chemotherapy protocols.
- Analysis of cardiotoxicity mechanisms.
- Discussion of perioperative cardiac monitoring and safeguarding strategies.
Main Results:
- Neoadjuvant chemotherapy offers benefits like tumor shrinkage and downstaging.
- Chemotherapy can lead to myocardial ischemia, arrhythmia, and hypertension.
- Effective anesthesia and cardioprotective measures are vital for patient outcomes.
Conclusions:
- Perioperative cardiac function monitoring and protection are essential for patients undergoing neoadjuvant chemotherapy.
- Precision anesthesia and cardioprotective strategies improve surgical success and survival.
- This review provides insights for anesthesia management in perioperative cancer care.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
430
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
430
01:26Cardiac Catheterization IV: Nursing Management
1.1K
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
1.1K
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
1.3K
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
1.3K
01:26Heart Failure Drugs: Inotropic Agents
1.9K
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
1.9K
01:28Cardiac Catheterization I: Pre-Procedure Overview
2.7K
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
2.7K
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
828
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
828