Perioperative use of β-blockers in oncological patients

Abstract

Background. One of the most common responses to surgical stress is the activation of the sympathetic nervous system, leading to a dramatic increase in circulating adrenaline and norepinephrine, which can potentially accelerate the spread of the tumor process in cancer patients. In this regard, it is relevant to review the results of studies devoted to the determination of the antitumor effect of β-blockers and their use in the perioperative treatment of cancer patients. Purpose – to analyze and summarize data on the oncogenic effects of catecholamines and to highlight the experience of using β-blockers in the perioperative treatment of cancer patients. Materials and methods. We used the electronic resources of Vernadsky National Library of Ukraine, Cochrane library and databases (Pubmed, Scopus). We analysed the results of studies conducted before August 2020. Results. A summary of the mechanisms by which excessive release of catecholamines may facilitate metastasis is provided. The analysis of clinical trials devoted to the study of the effects of perioperative use of propranolol and its combination with COX-2 inhibitors in cancer patients is conducted. Conclusions. Short-term perioperative therapy with propranolol and its combination with anti-inflammatory drugs may have antimetastatic effects and neutralize the immunosuppressive effects of surgical stress. Further elucidation of the clinical significance of perioperative propranolol treatment in cancer patients requires a 3–5-year study to assess the long-term relapse-free survival of cancer patients.