SummaryIntroductionCancer research has revolutionised the treatment, quality of life and life expectancy of people living with cancer. Systemic anti‐cancer treatments have expanded to involve not only cytotoxic drugs, but targeted drugs and immunotherapy. Although highly effective in many patients, these drugs can cause serious and sometimes life‐threatening adverse reactions. As part of their treatment, many patients living with cancer will be offered both systemic anti‐cancer therapy and surgery, and many patients will undergo recurrent episodes of both with the aims of cure, palliation or prolongation of life expectancy. It is important for anaesthetists to understand the effects of systemic anti‐cancer therapy on their patients.MethodsAn electronic literature search using was conducted in May 2024 for peer‐reviewed articles in English. An initial search of the terms ‘anaesthesia’ and ‘chemotherapy’ revealed that existing review literature was tailored towards the neoadjuvant setting and prompted this review to include the complications of targeted therapies, emergency care and intra‐operative administration of systemic anti‐cancer therapy to reflect this evolving field. A narrative approach was taken to discuss common regimens and their complications.ResultsThe review encompasses a wide range of sub‐topics including pharmacology; physiology; peri‐operative medicine; specialist surgery; adverse events; and safety. Data from multicentre trials that form the basis of current treatment regimens and practice were prioritised during the selection process. Smaller studies, case series and case reports were included to illustrate the rarer but clinically significant adverse effects of specific therapies.ConclusionsIt is important for anaesthetists to have a comprehensive understanding of the effects of systemic anti‐cancer therapies, including cytotoxic and immunotherapies. There are many potential toxicities and complications associated with these treatments, particularly in the context of emergency surgery and the administration of cytotoxic drugs within the operating theatre environment.

中文翻译：

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全身抗癌治疗和麻醉：叙述性回顾


摘要简介癌症研究彻底改变了癌症患者的治疗、生活质量和预期寿命。全身抗癌治疗已经扩展到不仅涉及细胞毒性药物，还涉及靶向药物和免疫疗法。尽管这些药物对许多患者非常有效，但这些药物可引起严重的、有时危及生命的不良反应。作为治疗的一部分，许多癌症患者将接受全身抗癌治疗和手术治疗，许多患者将同时接受这两种治疗的反复发作，目的是治愈、缓解或延长预期寿命。麻醉师了解全身抗癌治疗对患者的影响非常重要。方法于 2024 年 5 月对同行评审的英文文章进行了电子文献检索。对术语 “麻醉 ”和 “化疗 ”的初步检索显示，现有的综述文献是针对新辅助治疗的，并促使本综述纳入了靶向治疗的并发症、紧急护理和全身抗癌治疗的术中给药，以反映这一不断发展的领域。采用叙述方法来讨论常见的治疗方案及其并发症。结果本综述涵盖了广泛的子主题，包括药理学;生理学;围手术期医学;专科手术;不良事件;和安全。在选择过程中，优先考虑构成当前治疗方案和实践基础的多中心试验数据。纳入了较小的研究、病例系列和病例报告，以说明特定疗法的罕见但具有临床意义的不良反应。结论麻醉师全面了解全身抗癌疗法（包括细胞毒性和免疫疗法）的效果非常重要。这些治疗存在许多潜在的毒性和并发症，尤其是在急诊手术和手术室环境中使用细胞毒性药物的情况下。