Guidelines for Complications of Cancer Treatment Vol VIII Part B

ooooointravenously over 15 minutes in dose of 910 mg/m2 30minutes before administration of cisplatin. 12 – (LOE-2)Administration of other nephrotoxic drugs(aminoglycosides, non-steroidal anti-inflammatorydrugs) should be avoided. Patients with impaired renalfunction should not be given cisplatin.Role of amifostine in preventing neurotoxicity duecisplatin and paclitaxel has not been supported by thestudies. 12 – (LOE-2)Use of premedication (dexamethasone, H1 and H2receptor blockers) before the paclitaxel infusion canavoid the development of hypersensitivity reactions.-(LOE-1)Maintenance of oral hygiene with any oral protocolwhich include saline rinses, flossing and regular brushinghelps in preventing the development of oral mucositis.-(LOE-2)Some patients who have dihydropyrimidine deficiencydevelop severe life-threatening myelosuppression andmucositis after treatment with 5-FU and require dosemodification. Identification of these patients bymutational analysis can prevent life-threateningtoxicities.Managemento In most cases the occurrence of nausea and vomitingcan be effectively prevented by the above mentionedregimen of antiemetics; however management ofbreakthrough vomiting is largely empirical and includesbenzodiazepines and phenothiazines. Importance ofhydration and electrolyte replacement needs noemphasis.- (LOE-4)257