Guidelines for Complications of Cancer Treatment Vol VIII Part B

ooooooo direct interaction with the area postrema, which isaccessible to blood and cerebrospinal fluid–borneemetic stimuli.o Through cerebral cortex.Cisplatin induced nephropathy occurs due to tubularinjury caused by platinum DNA adduct formation. –(LOE-4)The ototoxicity due to cisplatin is cumulative and itoccurs due to cochlear damage and it leads to loss ofhigh frequency acuity.Cisplatin related peripheral neuropathy is likely due toirreversible accumulation of inorganic platinum in theneurons and it is also cumulative.Cisplatin and carboplatin can result in vasospasm andcan lead to myocardial ischemia and cerberovasculareventsPaclitaxel disrupts neuronal microtubule dynamics bystabilizing the microtubules against depolymerizationand leads to neuropathy due to demyelination and axonaldegeneration.There is a risk of acute hypersensitivity reactions duringinfusion of paclitaxel and carboplatin.Preventiono Prevention of side-effects allows administration ofchemotherapy in time and in full doses thus maintainingthe dose intensity to attain the desired effects.o The key for prevention is appropriate selection of cases.Patients who are elderly and those with poor performancestatus and multiple co-morbidities should not be takenfor chemoradiation or neoadjuvant chemotherapy. 11 –(LOE-2). Calculation of creatinine-clearance (Cockroft-Gault formula – (140-age) X body weight / 72 X serum255