Chemotherapy: strategies, effects, dosing, and handling

Definition and goals of chemotherapy

Chemotherapy is a cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents, including alkylating agents) given in standard regimens. It may be used with curative intent—often requiring combinations of drugs—or to prolong life and reduce symptoms in a palliative setting. In modern usage, chemotherapy refers to the non-specific action of intracellular poisons that inhibit mitosis (cell division) or induce DNA damage, distinguishing it from more selective hormonal therapies and targeted therapies that block specific growth signals. The goals of chemotherapy depend on the clinical situation and cancer stage. It can be used as first-line induction therapy for curative treatment, as neoadjuvant therapy before local treatment (such as surgery) to shrink tumors, and as adjuvant therapy after local treatment to eliminate remaining microscopic disease and reduce relapse. Other strategies include consolidation and intensification (post-remission approaches), maintenance therapy (repeated low-dose treatment to prolong remission), and salvage/palliative chemotherapy (without curative intent) to decrease tumor burden and increase life expectancy. Across regimens, treatment is typically delivered in cycles, with dosing and timing limited by toxicity and the need to continue killing tumor cells over multiple rounds.

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Curative versus palliative chemotherapy intents

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