Guidelines for Complications of Cancer Treatment Vol VIII Part B

More documents

Recommendations

Info

Risk factorsCentral compartment (Level VI) clearance (bilateral has higherrates)Lateral neck dissectionTotal thyroidectomy has higher rates as compared to subtotalor hemithyroidectomyThyroid cancer associated with thyrotoxicosisLesser rates seen in centres which perform larger volumes ofthyroid surgeryDiagnosisClinicalHypocalcaemia presents with signs of generalizedneuromuscular irritability including paraesthesia, musclecramps, laryngospasm, tetany and seizures. Thisneuromuscular irritability can also be displayed throughelicitation of Chvostek’s and Trousseau’s Sign.Chvostek’s sign: Tapping of face just anterior to ear andbelow zygomatic arch, produces twitching of ipsilateralfacial muscles suggestive of neuromuscular excitabilitycaused by hypocalcaemia.Trousseau’s sign: Inflating a sphygmomanometer about20mmHg above the systolic blood pressure produces amuscle contraction including flexion of wrist andmetacarpophalangeal joints, hyperextension of fingersand flexion of thumb on the palm, suggestive ofneuromuscular excitability caused by hypocalcaemia.Serum calciumTotal calcium < 9mg/dl (2.1mmol/L)Ionised calcium- < 4.5mg/dl ( 1.1mmol/L)199
Prevention Thorough knowledge of the thyroid-parathyroidanatomy. Meticulous surgical procedure. Capsular ligation of branches of the inferior thyroidartery as opposed to truncal ligation, may decrease ratesof hypocalcemia A drop of 75% baseline PTH or Postoperative PTHbelow 7-15pg/mL is considered as predictors for futurehypocalcaemia. Scenario of Unavoidable/Accidental damage toparathyroids – Parathyroid auto transplantation (PTHAT) Preferred site – Sternocleidomastoid. In case of extensive neck dissections, can usepectoralis major for implantation. In cases of surgery for medullary thyroid cancerassociated with MEN II A & IIB – Forearm is thepreferred choice.* PTHAT – After confirming the cut tissue is parathyroid glandin frozen section, 1mm slices of removed parathyroid glandare prepared and these are inserted into a pocket made in thesternocleidomastoid muscle.Management of hypocalcaemia:Depends on severity and presenting symptoms.Mainstay of treatment - Symptomatic patients require ivcalcium + oral calcium & Vit D3.Asymptomatic patients can be managed with oral supplementsalone.*It is also essential to measure serum magnesium in any patientwho is hypocalcaemic, as correction of hypomagnesaemia mustbe done to overcome PTH resistance before serum calciumwill return to normal.200
Page 1 and 2:
Guidelines forComplications ofCance
Page 3:
Dedicated toAll our patients atThe
Page 6 and 7:
Section IIHead & Neck 151Complicati
Page 8 and 9:
PrefaceTreatment of cancer by vario
Page 10:
Section — IGeneralContributorsDr.
Page 13 and 14:
6. Complications after breast recon
Page 15 and 16:
promises to reduce this risk of ser
Page 17 and 18:
preceded by increased sensory hyper
Page 19 and 20:
had significant lymphoedema. The fa
Page 21 and 22:
2. Smoking as a risk factor for wou
Page 23 and 24:
4. Preoperative core needle biopsy
Page 25 and 26:
eduction mammoplasty, and axillary-
Page 27 and 28:
postoperative wound infection follo
Page 29 and 30:
ablative surgical treatment for car
Page 31 and 32:
postoperative seroma formation usin
Page 33 and 34:
dressing consisted of a circumferen
Page 35 and 36:
mastectomies with axillary node cle
Page 37 and 38:
mastectomy for breast cancer. Early
Page 39 and 40:
monitored for the development of po
Page 41 and 42:
modality, and tumor stage distribut
Page 43 and 44:
26. Pain and other symptoms during
Page 45 and 46:
28. Coping, catastrophizing and chr
Page 47 and 48:
surgical technique at the time of m
Page 49 and 50:
0.001), 0.315 cm +/- 1.27 at the an
Page 51 and 52:
or heat and superficial incision is
Page 53 and 54:
RecommendationsA. Preparation of th
Page 55 and 56:
3. Mangram AJ, Horan TC, Pearson ML
Page 57 and 58:
Mild hypothermia increases blood lo
Page 59 and 60:
Perioperative Normothermia to Reduc
Page 61 and 62:
Priorities: Restoration of circulat
Page 63 and 64:
than 1.5 times control values but f
Page 65 and 66:
outcomes that may result from the u
Page 67 and 68:
Preoperative Preparation of the Pat
Page 69 and 70:
patients, or other patients who may
Page 71 and 72:
Obstruction can occur at the level
Page 74 and 75:
c. Administer face mask preoxygenat
Page 76 and 77:
5. The use of exhaled carbon dioxid
Page 78 and 79:
disorder) may occur after an episod
Page 80 and 81:
undergoing general anesthesia, eith
Page 82 and 83:
anesthesia awareness occurred in ea
Page 84 and 85:
The current guidelines are actually
Page 86 and 87:
o S - Strong Recommendation -Commit
Page 88 and 89:
oSource control ASAP after successf
Page 90 and 91:
oooWean steroids once vasopressors
Page 92 and 93:
Mechanical ventilation of sepsis-in
Page 94 and 95:
o CVVH offers easier management inh
Page 96 and 97:
critically ill patient that are con
Page 98 and 99:
Rivers E, Nguyen B, Havstad S, et a
Page 100 and 101:
in survival of 7.6%. By the second
Page 102 and 103:
parameters (gastric mucosal Pco2, s
Page 104 and 105:
syndrome. We therefore conducted a
Page 106 and 107:
Complications After Limb SalvageSur
Page 108 and 109:
local tumor and to preserve as much
Page 110 and 111:
femoral head to the center of the k
Page 112 and 113:
4. Griffin AM, Parsons JA, Davis AM
Page 114 and 115:
20. Roberts P, Chan D, Grimer RJ, e
Page 116 and 117:
An infection can have disastrous co
Page 118 and 119:
and facilitating reimplantation sur
Page 120 and 121:
features of a two-stage revision is
Page 122 and 123:
patients had an amputation. Two oth
Page 124 and 125:
its main role is confined to ruling
Page 126 and 127:
2. Capanna R, Morris HG, Campanacci
Page 128 and 129:
21. Wilson MG, Kelley K, Thornhill
Page 130 and 131:
39. Love C, Marwin SE, Tomas MB, Kr
Page 132 and 133:
5. A systematic review of 25 RCT’
Page 134 and 135:
(cefazolin or cefuroxime) or penici
Page 136 and 137:
should be based on the isolates fro
Page 138 and 139:
such as concomitant use of prophyla
Page 140 and 141:
Surgical techniqueAdherence to meti
Page 142 and 143:
2. Another small prospective random
Page 144 and 145:
Antibiotic prophylaxis for dental a
Page 146 and 147:
Antimicrobial Prophylaxis in Orthop
Page 148 and 149:
35. Tai CC, Nirvani AA, Holmes A, e
Page 150 and 151:
53. Parker MJ, Roberts C. Closed su
Page 152 and 153:
Vessel Related Issues in Sarcoma:Ev
Page 154 and 155:
sequences may be of value. They cau
Page 156 and 157:
an excellent alternative to amputat
Page 158: 5. Hünerbein M, Hohenberger P, Str
Page 162 and 163: Oral IncompetenceOral competence is
Page 164 and 165: flap is insensate and has no motor
Page 166 and 167: 16. R. Song, Y. Gao, Y. Song, Y. Yu
Page 168 and 169: The incidence is usually lower afte
Page 170 and 171: Late fibrotic phase: Attempted tiss
Page 172 and 173: Ref: A Lyons, N Ghazali/ British J
Page 174 and 175: 17. Store G, Boysen M. Mandibular o
Page 176 and 177: amino acids, proteins and traces of
Page 178 and 179: RTOG, EORTC and CTCAE, version 3 fo
Page 180 and 181: difference in the disease related p
Page 182 and 183: References1. Bourhis J, Rosine D. R
Page 184 and 185: with head and neck cancer. N Engl J
Page 186 and 187: MucositisMucositis is an inflammato
Page 188 and 189: Type of cancer: high risk for mucos
Page 190 and 191: Oral care protocol1. Brush all toot
Page 192 and 193: 3. El-Sayed S, Nabid A, ShelleyW, e
Page 194 and 195: 1) Recipient site problems- The maj
Page 196 and 197: estoration of vascular flow to tiss
Page 198 and 199: General Complications- Deep vein th
Page 200 and 201: Nerve Injuries(Recurrent and Superi
Page 202 and 203: paramedian position, it will result
Page 204 and 205: along with its variations, and a me
Page 206 and 207: anatomy as related to surgery of th
Page 210 and 211: Goal - To raise serum calcium level
Page 212 and 213: Pharyngocutaneous Fistula (PC Fistu
Page 214 and 215: Based on our institutional practice
Page 216 and 217: fistula: The Memorial University ex
Page 218 and 219: Risk factors (LOE-5)Patient factors
Page 220 and 221: oCircumferencial excision and inser
Page 222 and 223: y trauma or tumor, exposing the und
Page 224 and 225: Arytenoid cartilage is reported to
Page 226 and 227: Filntisis, G.A., et al. “Laryngea
Page 228 and 229: As high as 52% patients are detecte
Page 230 and 231: ManagementPostural exercisesDisorde
Page 232 and 233: References1) Objective assessment o
Page 234 and 235: Diagnosis Average time to hypothyro
Page 236 and 237: Management of Facial Nerve InjuryIn
Page 238 and 239: 2. Interposition or cable graft (to
Page 240 and 241: Prevention of corneal exposure Tars
Page 242 and 243: flushing) and localized sweating (g
Page 244 and 245: Other options :1. Intracutaneous in
Page 246 and 247: Shoulder Dysfunction or PainfulShou
Page 248 and 249: EMG studies on scapulo-humeral and
Page 250 and 251: Chyle Fistula after Neck Dissection
Page 252 and 253: Rationale:LCTs, which constitute 70
Page 254 and 255: CSF Leak after Craniofacial Resecti
Page 256 and 257: to the muscle to recreate the orbit
Page 258 and 259:
Conservative treatmentIt is logical
Page 260 and 261:
Complications Associated with use o
Page 262 and 263:
Following is the example of hematol
Page 264 and 265:
ooooooo direct interaction with the
Page 266 and 267:
ooooointravenously over 15 minutes
Page 268 and 269:
in most of the patients. The common
Page 270:
Section — IIIRadiotherapyContribu
Page 273 and 274:
nodes are involved or suspected to
Page 275 and 276:
function. In general, with conventi
Page 277 and 278:
like ultrasonography, CT scan, endo
Page 279 and 280:
catheter passed through the anus in
Page 281 and 282:
Acute symptoms usually subside seve
Page 283 and 284:
granulocytopenia, thrombocytopenia
Page 285 and 286:
adiation therapy), IMRT (intensity-
Page 287 and 288:
patients who have received radical
Page 289 and 290:
ate expected in the standard popula
Page 292 and 293:
adjusting for competing causes of d
Page 294 and 295:
therapy (3D-CRT) and intensity modu
Page 296 and 297:
attributed to use of cisplatin base
Page 298 and 299:
Conclusion:Incidence of SMN is incr
Page 300 and 301:
11. Travis LB, Fossa SD, Schonfeld
Page 302 and 303:
adiation-related solid SMNs will in
Page 304 and 305:
0.71, p
Page 306 and 307:
5.65%) within 45 years after a CNS
Page 308 and 309:
adiation damage though supporting v
Page 310 and 311:
without calcification. Inflammation
Page 312 and 313:
patients treated using the original
Page 314 and 315:
incidence of valvular thickening at
Page 316 and 317:
12. Hancock S, Hoppe R. Long-term c
Page 318 and 319:
syndrome and bronchiolitis oblitera
Page 320 and 321:
Darby SC, McGale P, Taylor CW, Peto
Page 322 and 323:
undertaken, based on individual pat
Page 324 and 325:
Pathophysiological Aspects:The func
Page 326 and 327:
Symptoms: Symptoms related to pulmo
Page 328 and 329:
Prevention of Pneumonitis and Lung
Page 330 and 331:
genotyping analysis of single nucle
Page 332 and 333:
Registry of Patients. We computed I
Page 334 and 335:
eceived elective nodal irradiation
Page 336 and 337:
Int J Radiat Oncol Biol Phys. 1995
Page 338 and 339:
worsening during the treatment shou
Page 340 and 341:
Differential Diagnosis: This sign i
Page 342 and 343:
Dose Incidence Comments Author>30 G
Page 344 and 345:
PET scan findings have been describ
Page 346 and 347:
3. Pallis CA, Louis S, Morgan RL.:
Page 348 and 349:
24. Abbatucci JS, Delozier T, Quint
Page 350 and 351:
and summarized into specific recomm
Page 352 and 353:
adequate. With the increasing use o
Page 354 and 355:
Complications are mainly described
Page 356 and 357:
IQ decline is associated with sever
Page 358 and 359:
activity’ of a person, essentiall
Page 360 and 361:
development after brain tumor thera
Page 362 and 363:
Highest relative risk of second can
Page 364 and 365:
Suggested Reading:A) Neuropsycholog
Page 366 and 367:
aseline. Male sex, longer symptomat
Page 368 and 369:
number of patients. Cognition was p
Page 370 and 371:
16 years, the corresponding value w
Page 372 and 373:
15 of 20 (75%) subjects, endocrine
Page 374 and 375:
OBJECTIVE: To assess cerebrovascula
Page 376 and 377:
hypometabolism. Of the 17 patients
Page 378:
10-20 months, with an average of 18
Page 382 and 383:
Febrile NeutropeniaNeutropenia is w
Page 384 and 385:
Approach to initial antibiotic use
Page 386 and 387:
Known colonization with Penicillin/
Page 388 and 389:
DocumentedinfectionsSuggesteddurati
Page 390 and 391:
Zygomycosis and other mold infectio
Page 392 and 393:
Overall risk Examples Febrile neutr
Page 394 and 395:
Broad spectrum DOSE Spectrum Commen
Page 396 and 397:
Page 398 and 399:
Page 400 and 401:
Role of G-CSF-Primary Prophylaxis:R
Page 402 and 403:
Chemotherapy Induced Nausea andVomi
Page 404 and 405:
Level I Level II Level III Level IV
Page 406 and 407:
Types & doses of AntiemeticsDrug &
Page 408 and 409:
supported by a meta-analysis, which
Page 410 and 411:
and follow-up after treatment for n
Page 412 and 413:
day 1; aprepitant and dexamethasone
Page 414 and 415:
2-3: APR 80 mg every day) or a cont
Page 416 and 417:
Late Effects in Childhood CancerSur
Page 418 and 419:
to increase their awareness about l
Page 420 and 421:
Contd...Score2BStatement of consens
Page 422 and 423:
6 Kurkure PA, Achrekar S, Uparkar U
Page 424 and 425:
nonirradiated group did not differ
Page 426 and 427:
Gaslini Children’s Research Hospi
Page 428 and 429:
Our ACT model has 3 basic facets; p
Page 430 and 431:
The relative risk of developing TLS
Page 432 and 433:
the excretion of uric acid and phos
Page 434 and 435:
hyperuricemia (> 7.5 mg/dL), treatm
Page 436 and 437:
hydration, and the administration o
Page 438 and 439:
which the different drugs are admin
Page 440 and 441:
Table 2. Cairo-Bishop clinical Tumo
Page 442 and 443:
Table 4 Patient Stratification by R
Page 444 and 445:
Table 6 Management of Electrolyte A
Page 446 and 447:
of TLS and improve the management o
Page 448 and 449:
4. Efficacy and safety of rasburica
Page 450 and 451:
Pulmonary Toxicity of Antineoplasti
Page 452 and 453:
Though there are many chemotherapeu
Page 454 and 455:
corticosteroids with variable respo
Page 456 and 457:
Nephrotoxicity ofChemotherapeutic D
Page 458 and 459:
associated with use of carbopltin c
Page 460 and 461:
Table 2 Chemotherapeutics Requiring
Page 462 and 463:
against ifosfamide nephrotoxicity.
Page 464 and 465:
The incidence of mucositis involvin
Page 466 and 467:
7. Obesity - Probably due to over d
Page 468 and 469:
conditioning treatment and for 3 da
Page 470 and 471:
References and Recommended Readings
Page 472 and 473:
metabolism for activity, cyclophosp
Page 474 and 475:
delays excretion and eventually res
Page 476 and 477:
Combination Chemotherapy:Combinatio
Page 478 and 479:
Vincristine: No dose reduction if b
Page 480 and 481:
19. Slichenmyer WJ, Rowinsky EK, Gr
Page 482 and 483:
AlopeciaCommon drugs causing alopec
Page 484 and 485:
dependent, occurring from 8 days to
Page 486 and 487:
Cancer Induced Anemia (CIA)Introduc
Page 488 and 489:
system. There is an upregulation of
Page 490 and 491:
time may represent increasing anemi
Page 492 and 493:
(rHuEPO) whiles the other received
Page 494 and 495:
Table 3. Improvements in Hemoglobin
Page 496 and 497:
2. Groopman JE, Itri LM. Chemothera
Page 498 and 499:
epoetin alfa versus oral iron or no
Page 500 and 501:
NOTES
show all

Guidelines for Complications of Cancer Treatment Vol VIII Part B

Create successful ePaper yourself

Delete template?

Save as template?