Bulletin of Stomatology and Maxillofacial Surgery
2025; 268–280
Shared with The Gufo

THE GLOBAL CHALLENGE OF CHEMOTHERAPY TOXICITY: RETHINKING SUPPORTIVE CARE IN MODERN ONCOLOGY

Taniya Mary Martin*, Jabir Khalid, Meenakshi Kumar

Research Scholar Saveetha Dental College and hospitals,Department of Anatomy Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai-600077, Tamil Nadu, India · Professor Department of Physiology Saveetha Medical College and Hospital Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai-602105, Tamil Nadu, India · Assistant Professor, Department of Anatomy Saveetha Dental College and hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai-600077, Tamil Nadu, India

Received: 2025-09-18 · Published: 2025-09-07

© 2025 The Author(s) and the original publisher.

CC BY-NC 4.0 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Shared article.
Original title
THE GLOBAL CHALLENGE OF CHEMOTHERAPY TOXICITY: RETHINKING SUPPORTIVE CARE IN MODERN ONCOLOGY
Authors
Taniya Mary Martin, Jabir Khalid, Meenakshi Kumar
Source journal
Bulletin of Stomatology and Maxillofacial Surgery
Published
2025-09-07
Licence
Creative Commons Attribution-NonCommercial 4.0 International
Original
https://doi.org/10.58240/1829006X-2025.21.8-268

Abstract

Chemotherapy remains a central component of cancer treatment, yet its therapeutic efficacy is frequently overshadowed by a broad spectrum of systemic toxicities that severely compromise patient quality of life. This adverse effect – ranging from nausea, vomiting, and anorexia to mucositis, diarrhea, fatigue, and alopecia, are driven by complex molecular and cellular mechanisms that extend far beyond the direct cytotoxicity to malignant cells. Emerging evidence highlights the role of inflammatory cytokine cascades, oxidative stress, neurotransmitter imbalance, mitochondrial dysfunction, and epithelial barrier disruption in mediating these side effects. For instance, serotonin release and 5-HT3 receptor activation underlie chemotherapy induced emesis, while hypothalamic dysregulation contributes to anorexia. Mucositis results from ROS mediated NF-κB activation and epithelial apoptosis, whereas diarrhea is linked to SN-38 induced enterocyte damage, tight junction disruption, and microbiome imbalance. Fatigue stems from altered HPA axis signalling and mitochondrial energy deficits, while alopecia arises from p53 mediated apoptosis in hair follicle keratinocytes. Understanding these multifaceted mechanisms provides a foundation for the development of targeted adjunct therapies, particularly those driven from biocompatible and multifunctional natural agents. This review presents an integrated molecular perspective on chemotherapy induced toxicities and explores innovative strategies for their prevention and management.
1 / ? 100% Open in new tab Download Cite

Loading the full text…

Download Follow Updates