Guidelines for Complications of Cancer Treatment Vol VIII Part B

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Suggested Reading:1. Hall EJ. Radiobiology for the radiologist.5 th edition.Philadelphia: Lippincott Williams & Wilkins ; 2000.2. Emami B, Lyman J, Brown A, et al. Tolerance of normaltissue to therapeutic irradiation. Int J Radiat Oncol BiolPhys. 1991 May 15;21(1):109-22.3. Trotti A, Colevas AD, Setser A et al., CTCAE v3.0:Development of a comprehensive grading system for theadverse effects of cancer treatment, Semin Radiat Oncol2003;13:176–181.4. Milano MT, Constine LS, Okunieff P. Normal tissuetolerance dose metrics for radiation therapy of majororgans. Semin Radiat Oncol. 2007 Apr;17(2):131-40.5. Jervoise Andreyev. Gastrointestinal symptoms afterpelvic radiotherapy: a new understanding to improvemanagement of symptomatic patients. Lancet Oncol2007 Nov;8(11):1007-17.6. Perez CA, Grigsby PW, Lockett MA et al. Radiationtherapy morbidity in carcinoma of the uterine cervix:dosimetric and clinical correlation. Int J Radiat OncolBiol Phys. 1999 Jul 1;44(4):855-66.7. Schultheiss TE, Lee WR, Hunt MA, et al. Late GI andGU complications in the treatment of prostate cancer.Int J Radiat Oncol Biol Phys. 1997 Jan 1;37(1):3-11.8. RTOG/EORTC LENT SOMA Tables: Table of Contents.Radiother Oncol. 1995;35:17-60.9. Kochhar R, Patel F, Dhar A et al. Radiation-inducedproctosigmoiditis. Prospective, randomized, doubleblindcontrolled trial of oral sulfasalazine plus rectalsteroids versus rectal sucralfate. Dig Dis Sci. 1991Jan;36(1):103-7.10. Denton A, Forbes A, Andreyev HJN, Maher EJ. Nonsurgicalinterventions for late radiation proctitis in277
patients who have received radical radiotherapy to thepelvis. Cochrane Database Syst Rev 2002; 1: CD003455.11. Ben-Soussan E, Antonietti M, Savoye G, et al. Argonplasma coagulation in the treatment of hemorrhagicradiation proctitis is efficient but requires a perfectcolonic cleansing to be safe. Eur J Gastroenterol Hepatol2004; 16: 1315–18.12. Dose and volume specifications for reportingintracavitary therapy in gynecology. ICRU Report#38;1985.13. Marks LB, Carroll PR, Dugan TC,et al. The response ofthe urinary bladder, urethra, and ureter to radiation andchemotherapy. Int J Radiat Oncol Biol Phys. 1995 Mar30;31(5):1257-80.14. Hay-Smith J, Herbison P, Ellis G et al. Whichanticholinergic drug for overactive bladder symptomsin adults. Cochrane Database Syst Rev. 2005 Jul20;(3):CD005429.15. Chong KT, Hampson NB, Corman JM. Early hyperbaricoxygen therapy improves outcome for radiation-inducedhemorrhagic cystitis. Urology. 2005 Apr;65(4):649-53.16. Jensen PT, Groenvold M, Klee MC, et al. Longitudinalstudy of sexual function and vaginal changes afterradiotherapy for cervical cancer. Int J Radiat Oncol BiolPhys. 2003 Jul 15;56(4):937-49.17. Blomlie V, Rofstad EK, Talle K, et al. Incidence ofradiation-induced insufficiency fractures of the femalepelvis: evaluation with MR imaging. AJR Am JRoentgenol. 1996 Nov;167(5):1205-10.18. Beriwal S, Gan GN, Heron DE, et al. Early clinicaloutcome with concurrent chemotherapy and extendedfield,intensity-modulated radiotherapy for cervicalcancer. Int J Radiat Oncol Biol Phys. 2007 May 1;68(1):166-71. Epub 2007 Feb 22.278
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Guidelines forComplications ofCance
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Dedicated toAll our patients atThe
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Section IIHead & Neck 151Complicati
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PrefaceTreatment of cancer by vario
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Section — IGeneralContributorsDr.
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6. Complications after breast recon
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promises to reduce this risk of ser
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preceded by increased sensory hyper
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had significant lymphoedema. The fa
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2. Smoking as a risk factor for wou
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4. Preoperative core needle biopsy
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eduction mammoplasty, and axillary-
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postoperative wound infection follo
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ablative surgical treatment for car
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postoperative seroma formation usin
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dressing consisted of a circumferen
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mastectomies with axillary node cle
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mastectomy for breast cancer. Early
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monitored for the development of po
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modality, and tumor stage distribut
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26. Pain and other symptoms during
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28. Coping, catastrophizing and chr
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surgical technique at the time of m
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0.001), 0.315 cm +/- 1.27 at the an
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or heat and superficial incision is
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RecommendationsA. Preparation of th
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3. Mangram AJ, Horan TC, Pearson ML
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Mild hypothermia increases blood lo
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Perioperative Normothermia to Reduc
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Priorities: Restoration of circulat
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than 1.5 times control values but f
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outcomes that may result from the u
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Preoperative Preparation of the Pat
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patients, or other patients who may
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Obstruction can occur at the level
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c. Administer face mask preoxygenat
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5. The use of exhaled carbon dioxid
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disorder) may occur after an episod
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undergoing general anesthesia, eith
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anesthesia awareness occurred in ea
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The current guidelines are actually
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o S - Strong Recommendation -Commit
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oSource control ASAP after successf
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oooWean steroids once vasopressors
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Mechanical ventilation of sepsis-in
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o CVVH offers easier management inh
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critically ill patient that are con
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Rivers E, Nguyen B, Havstad S, et a
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in survival of 7.6%. By the second
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parameters (gastric mucosal Pco2, s
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syndrome. We therefore conducted a
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Complications After Limb SalvageSur
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local tumor and to preserve as much
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femoral head to the center of the k
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4. Griffin AM, Parsons JA, Davis AM
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20. Roberts P, Chan D, Grimer RJ, e
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An infection can have disastrous co
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and facilitating reimplantation sur
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features of a two-stage revision is
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patients had an amputation. Two oth
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its main role is confined to ruling
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2. Capanna R, Morris HG, Campanacci
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21. Wilson MG, Kelley K, Thornhill
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39. Love C, Marwin SE, Tomas MB, Kr
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5. A systematic review of 25 RCT’
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(cefazolin or cefuroxime) or penici
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should be based on the isolates fro
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such as concomitant use of prophyla
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Surgical techniqueAdherence to meti
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2. Another small prospective random
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Antibiotic prophylaxis for dental a
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Antimicrobial Prophylaxis in Orthop
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35. Tai CC, Nirvani AA, Holmes A, e
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53. Parker MJ, Roberts C. Closed su
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Vessel Related Issues in Sarcoma:Ev
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sequences may be of value. They cau
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an excellent alternative to amputat
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5. Hünerbein M, Hohenberger P, Str
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Oral IncompetenceOral competence is
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flap is insensate and has no motor
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16. R. Song, Y. Gao, Y. Song, Y. Yu
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The incidence is usually lower afte
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Late fibrotic phase: Attempted tiss
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Ref: A Lyons, N Ghazali/ British J
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17. Store G, Boysen M. Mandibular o
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amino acids, proteins and traces of
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RTOG, EORTC and CTCAE, version 3 fo
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difference in the disease related p
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References1. Bourhis J, Rosine D. R
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with head and neck cancer. N Engl J
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MucositisMucositis is an inflammato
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Type of cancer: high risk for mucos
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Oral care protocol1. Brush all toot
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3. El-Sayed S, Nabid A, ShelleyW, e
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1) Recipient site problems- The maj
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estoration of vascular flow to tiss
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General Complications- Deep vein th
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Nerve Injuries(Recurrent and Superi
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paramedian position, it will result
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along with its variations, and a me
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anatomy as related to surgery of th
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Risk factorsCentral compartment (Le
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Goal - To raise serum calcium level
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Pharyngocutaneous Fistula (PC Fistu
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Based on our institutional practice
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fistula: The Memorial University ex
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Risk factors (LOE-5)Patient factors
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oCircumferencial excision and inser
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y trauma or tumor, exposing the und
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Arytenoid cartilage is reported to
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Filntisis, G.A., et al. “Laryngea
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As high as 52% patients are detecte
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ManagementPostural exercisesDisorde
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References1) Objective assessment o
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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
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Page 268 and 269: in most of the patients. The common
Page 270: Section — IIIRadiotherapyContribu
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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: adiation therapy), IMRT (intensity-
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
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Int J Radiat Oncol Biol Phys. 1995
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worsening during the treatment shou
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Differential Diagnosis: This sign i
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Dose Incidence Comments Author>30 G
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PET scan findings have been describ
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3. Pallis CA, Louis S, Morgan RL.:
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24. Abbatucci JS, Delozier T, Quint
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and summarized into specific recomm
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adequate. With the increasing use o
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Complications are mainly described
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IQ decline is associated with sever
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activity’ of a person, essentiall
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development after brain tumor thera
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Highest relative risk of second can
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Suggested Reading:A) Neuropsycholog
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aseline. Male sex, longer symptomat
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number of patients. Cognition was p
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16 years, the corresponding value w
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15 of 20 (75%) subjects, endocrine
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OBJECTIVE: To assess cerebrovascula
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hypometabolism. Of the 17 patients
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10-20 months, with an average of 18
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Febrile NeutropeniaNeutropenia is w
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Approach to initial antibiotic use
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Known colonization with Penicillin/
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DocumentedinfectionsSuggesteddurati
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Zygomycosis and other mold infectio
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Overall risk Examples Febrile neutr
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Broad spectrum DOSE Spectrum Commen
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Role of G-CSF-Primary Prophylaxis:R
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Chemotherapy Induced Nausea andVomi
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Level I Level II Level III Level IV
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Types & doses of AntiemeticsDrug &
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supported by a meta-analysis, which
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and follow-up after treatment for n
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day 1; aprepitant and dexamethasone
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2-3: APR 80 mg every day) or a cont
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Late Effects in Childhood CancerSur
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to increase their awareness about l
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Contd...Score2BStatement of consens
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6 Kurkure PA, Achrekar S, Uparkar U
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nonirradiated group did not differ
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Gaslini Children’s Research Hospi
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Our ACT model has 3 basic facets; p
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The relative risk of developing TLS
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the excretion of uric acid and phos
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hyperuricemia (> 7.5 mg/dL), treatm
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hydration, and the administration o
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which the different drugs are admin
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Table 2. Cairo-Bishop clinical Tumo
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Table 4 Patient Stratification by R
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Table 6 Management of Electrolyte A
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of TLS and improve the management o
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4. Efficacy and safety of rasburica
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Pulmonary Toxicity of Antineoplasti
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Though there are many chemotherapeu
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corticosteroids with variable respo
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Nephrotoxicity ofChemotherapeutic D
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associated with use of carbopltin c
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Table 2 Chemotherapeutics Requiring
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against ifosfamide nephrotoxicity.
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The incidence of mucositis involvin
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7. Obesity - Probably due to over d
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conditioning treatment and for 3 da
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References and Recommended Readings
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metabolism for activity, cyclophosp
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delays excretion and eventually res
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Combination Chemotherapy:Combinatio
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Vincristine: No dose reduction if b
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19. Slichenmyer WJ, Rowinsky EK, Gr
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AlopeciaCommon drugs causing alopec
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dependent, occurring from 8 days to
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Cancer Induced Anemia (CIA)Introduc
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system. There is an upregulation of
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time may represent increasing anemi
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(rHuEPO) whiles the other received
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Table 3. Improvements in Hemoglobin
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2. Groopman JE, Itri LM. Chemothera
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epoetin alfa versus oral iron or no
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NOTES
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