How to deal with the side effects of immunotherapy for patients with renal cancer

Immunotherapy is a limited weapon for the treatment of renal cancer. It must be emphasized that: ① Immunotherapy is used as an adjuvant treatment for localized renal cancer or locally advanced renal cancer after surgery. Its efficacy is uncertain, and whether it can be used to prevent tumor recurrence after surgery has not yet been determined; ② Immunotherapy is used for metastatic disease. Its efficacy is limited. This is mainly because chemotherapy and radiotherapy have poor efficacy for renal cancer. The treatment of locally advanced and metastatic renal cancer has been a difficult problem for urologists for many years, so immunotherapy has become metastatic. Immunotherapy will produce some side effects, so how to deal with it? Most immune preparations such as interferon and IL-2 are a type of regulatory protein with broad biological activity produced by inducing biological cells with inducers. They play a powerful anti-cancer effect in the body, but also cause side effects in the body. These side effects include: general symptoms: fatigue, fever, sweating, fatigue, headache, flu-like symptoms, shivering, weight loss, dizziness; skin: injection site inflammation, injection site reaction, hair loss, itching, rash, dry skin; digestive tract: dry mouth, anorexia, nausea, vomiting, abdominal pain, diarrhea; respiratory tract: pharyngitis, cough, dyspnea; muscle and joint: joint pain, muscle and bone pain; mental: insomnia, decreased concentration, depression, anxiety, emotional instability, irritability; blood system: bone marrow suppression, mainly anemia, leukopenia, thrombocytopenia. The most common of these is fever. Interferon releases prostaglandin E2 to regulate the body temperature center and increase the body temperature. 90% of patients will have fever, with a body temperature of 38 to 40°C, which often occurs within 4 to 8 hours after medication and lasts for 4 to 12 hours. Routine physical cooling, or taking acetaminophen or other antipyretic analgesics can relieve the symptoms. If the persistent high fever cannot be tolerated, the dose can be reduced or the drug can be discontinued. Fever is obviously related to the dose and gradually alleviates with the extension of the course of treatment. Most skin reactions, gastrointestinal reactions, etc. can be relieved through symptomatic treatment. Long-term use of interferon may cause neutropenia, anemia, and idiopathic thrombocytopenic purpura. Adverse reactions of the blood system are mostly reversible and can be recovered after reducing the dose and stopping the drug. Blood cell-raising drugs such as leucine, shark liver alcohol, and VitB6 can also be used. If necessary, G-CSF (macrophage colony stimulating factor) 300ug can be used, subcutaneously injected 3 times a week.

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