Guidelines for Complications of Cancer Treatment Vol VIII Part B

oooin many trials though the difference did not reachstatistical significance. 6 –(LOE-2)The most frequent and distressing toxicity of cisplatinis nausea and vomiting. It can result in both acute anddelayed emesis (>90% risk) so much so that it has beenused as a model to describe acute and delayed emesis. 10–(LOE-2)Incidence of ototoxicity, nephrotoxicity andneurotoxicity is less with carboplatin however it is moremyelosuppressive. – (LOE-1)The combination chemotherapy (taxanes based tripletsor cisplatin and 5-FU combination) 4,5 which is used inneoadjuvant setting can cause grade 3 / 4 neutropenia(52-76%), anemia(9-12%), thrombocytopenia (5-18%),leucopenia (22-41%), febrile neutropenia (2-5%),alopecia (0-20%), stomatitis (4-11%), nausea andvomiting (4.5-6%),anorexia (0.6-4%), diarrhea (2-4%),constipation (0.6%), ototoxicity (0-3%), andneurotoxicity (0.6-1%). – (LOE-2)Etiologyo These side-effects of chemotherapeutic regimens are dueto their cytotoxic action on rapidly proliferative normalcells of bone marrow, hair follicles, and gastro-intestinaltract mucosa resulting in anemia, leucopenia,thrombocytopenia, alopecia, mucositis and diarrhea.o Antineoplastic agents may cause emesis through effectsat a number of sites. 10 (LOE-2)o Action of chemotherapy drugs on small bowelwhich results in neurotransmitter mediatedstimulation of the nucleus tractus solitarius (NTS),and the area postrema through vagal nerve.254