Guidelines for Complications of Cancer Treatment Vol VIII Part B

ooCisplatin, as single agent is the currently recommendeddrug for concurrent chemoradiotherapy protocols 6 andforms the backbone of the triplets used as neoadjuvantchemotherapy. 4,5 (LOE-1)Neoadjuvant chemotherapy is based on taxane-basedtriplets – docetaxel, cisplatin and 5 FU or paclitaxel,cisplatin and 5 FU – (LOE-1). Other triplet which hasbeen used in some neoadjuvant studies is paclitaxel,ifosfamide and cisplatin – (LOE-3).Toxicity Profileo Chemotherapy side effects can be divided into –hematological - All the above mentioned drugs have thepropensity to cause myelosuppression . anemia, neutropenia,leucopenia, thrombocytopenia, febrile neutropenia.non-hematological -mucositis, nausea, vomiting, diarrhea,constipation, weight loss, lethargy, alopecia, neurotoxicity,ototoxicity, nephrotoxicity, skin rashes etc. Cisplatin canresult in nephrotoxicity, ototoxicity and neurotoxicity. Carboplatin has more myelosuppressive potential thanCisplatin. However its potential to cause nephrotoxicity,ototoxicity and neurotoxicity is much less than cisplatin. Paclitaxel causes peripheral neuropathy, myelosuppression,alopecia, diarrhea, hypersensitivity reactions and rarelybradyarrythmias. Docetaxel can result in mucositis,myelosuppression, fluid retention and skin rashes. 5- FUcauses mucositis, loose motions, vomiting, hand-footsyndrome and rarely can result in coronary vasospasm.Grading of toxicities is done usually with the help of NationalCancer Institute common toxicity criteria (ctc). This makesassessment of toxicity more objective and helps in decidingdose modification.252