Docetaxel

Docetaxel : anticancer taxoide

The taxoides, the family of alkaloids which docetaxel is based, have a similarthis last one being most collectively met in Europe. chemical structure molecules extracted from acorce d'If, Taxus brevifolia and taxus Baccata, this last one being most collectively met in Europe. We obtain, by hemisynthesis from natural products or by synthesis, by-products having a more specific action while being less toxic than the natural molecules. Taxoides settles on tubules and prevent their depolymerisation. In addition, they promote the transformation of tubulin in micotubules. The persistence of micotubules of the reel crossing the cell throughout prevents it from dividing. They act on cells with fast division at the level of the marrow, the digestive tract and the gonads. They are used in the treatment of breast cancer, bronchus, ovarian, malignant melanoma, and leukemia. The main side effects of taxoides in general were myelosuppression, particularly neurotropie, neuropathy, alopecia. Unlike the docetaxel, paclitaxel causes hypersensitivity reactions, allergic reactions which can go until the anaphylactic shock.

Docetaxel : Side effects

Thanks to the use of preventive or corrective therapeutic measures, we can avoid even decreasing the intensity of certain complications (nausea, vomits with the use of the antagonists of the 5 HT3 receivers or " sétrons "), possibly prevent(warn) them or decrease the gravity (adapted use of antibiotics, hematopoietic growth factors, or erythroproteine). We can distinguish the "common" side effects, commonly reported with most of the molecules used in chemotherapy and "specific" adverse, more specific to each molecule. In practice, chemotherapy rarely uses a single molecule and the side effects (common and specific) can be combined with a poly-chemotherapy. They can also provide with different chronologies. A fast coordination is always necessary between the various practitioners required to follow the patient and the service of chemotherapy or oncology, which most often take the therapeutic relay. The docetaxel, as anticancerous taxoide, is often part of the drugs used in chemotherapy, and is therefore subject to the side effects described above. More specifically, the use of docetaxel cause adverse reactions following :

Oedemas

The docetaxel can lead to peripheral edema, often moderate importance, but unpredictable occurrence, slowly reversible. The appearance of these oedemas seems dependent dose, linked to a cumulative dose, but seem much less frequent or at least their appearance is delayed, since a medication is recommended (corticoid one at several hours before the drip). Diuretics (furosemic or spironolactone) are recommended in case of oedemas or of annoying effusions linked to the docetaxel.

Neurlogic Complications

Taxoides as docetaxel are mostly at the origin of sensory polynevrites or sensitivo-driving, generally dose dependent and reversible. An early detection can avoid crippling attacks. The interrogation and the examination highlight parasthesis feet and hands and sometimes superficial sensory disorder and/or motor deficit distal of lower limbs, symmetrical. The taxoides (paclitaxel and docetaxel) are also responsible in a predominantly sensory neuropathy, revealed mostly by parathesis, cumulative dose dependant usually reversible but sometimes slowly.

Dermatological Complications

The changes of nail color (appearance of white or black streaks) are linked to the nail regrowth after cessation of treatment. An onycholysis is possible especially after treatment with docetaxel.