CT Findings of Chemotherapy-induced Toxicity: What Radiologists Need to Know about the Clinical and Radiologic Manifestations of Chemotherapy Toxicity

Authors: Jean M. Torrisi, Lawrence H. Schwartz, Marc J. Gollub, Michelle S. Ginsberg, George J. Bosl and Hedvig Hricak,

Cancer chemotherapy has evolved from cytotoxic agents
and now includes several new agents that target specific
molecules responsible for the regulation of cell growth,
nutrient supply, and differentiation. These molecularly
targeted therapies have a different mechanism of action
than do classic cytotoxic agents, which predominantly at-
tack rapidly proliferating cells. Not surprisingly, therefore,
the toxicity of targeted and cytotoxic agents may differ
in both clinical and radiologic presentation. Many of the
toxicities of targeted therapies are not cumulative or dose
dependent, some are asymptomatic, and others may first
manifest radiologically. It is imperative that radiologists be
aware of these toxicities and that they learn to recognize
the relevant findings so that they can provide a complete
differential diagnosis and thus play an important role in
patient care.