The Role of Radioprotectors and Immunotropes in the Prevention of Radiation Reactions and Complications
The review is devoted to the drug prevention and treatment of radiation reactions and complications in cancer patients. The search for optimal radioprotectors remains relevant today. An ideal radioprotector should have cytoprotective, regenerative, antioxidant, and immune system stimulating properties. The review describes the pathogenetic aspects, methodology of application, the effectiveness of radioprotectors of chemical and natural origin, drugs with a pronounced immunotropic effect. The use of the only radioprotectant of chemical origin, the prodrug amifostine, has been recognized as inappropriate in wide clinical practice due to its high toxicity and inconvenience of administration. In order to prevent chemoradiation injuries, the possibility of using antioxidant, anti-inflammatory properties of low-toxic natural radioprotectors: flavonoids, phenolic acids, lycopene, alkaloids, polysaccharides, phytohormones is discussed. A group of immunomodulators was tested as elements of accompanying therapy. The use of synthetic immunotropes (levamisole, Lycopid, Imunofan, Polyoxidonium, Galavit, Glutoxim, tetrachlorodecaoxide) is advisable in the postoperative period. Natural immunomodulators (Erbisol, Derinat) demonstrate effectiveness at different stages of complex treatment of malignant tumors. Expressed immunomodulatory, anti-inflammatory, regenerating, hematopoietic effects are characteristic of deoxyribonucleic acid preparations. Their use is justified at the stages of polychemotherapy, competitive chemoradiation and radiation therapy to stimulate hematopoiesis, reduce the cardio- and myelotoxicity of the treatment. The versatility of DNA drugs increases the likelihood of full and continuous courses of radiotherapy up to radical, helps to lengthen the disease-free period, and improves the quality of life of patients. The expanding evidence base of clinical effectiveness justifies the continuation of research, the development of standards, clinical guidelines for optimizing the accompanying therapy of chemoradiation treatment.