Guidelines for Complications of Cancer Treatment Vol VIII Part B

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genotyping analysis of single nucleotide polymorphisms intransforming growth factor beta1, transforming growth factorbeta1 pathway genes, and other cytokines. Genetic variabilityand the complexity of RP and its underlying molecularmechanisms make identification of biological risk predictorschallenging. Further research is needed to develop moreeffective risk predictors of RP. Understanding new molecularmechanisms such as those involving cytokine release in theinitiation of the fibrosis process provide new opportunitiesfor prevention and treatment. Appropriate agents such ascertain interferons that inhibit fibrosis-promoting growthfactors hold potential to be used during therapy, resulting inenhanced therapeutic ratio.References:1. Van Dyk J, Keane TJ, Kan S, et al. Radiation pneumonitisfollowing large single dose irradiation: A re-evaluationbased on absolute dose to lung. Int J Radiat Oncol BiolPhys 1981; 7:461–467.2. Emami B, Lyman J, Brown A, et al. Tolerance of normaltissue to therapeutic irradiation. Int J Radiat Oncol BiolPhys 1991;21:109–122.3. Gross, N. J. Pulmonary effects of radiation therapy. Ann.Intern. Med. 86:81-92; 1977.4. Morgan, G. M.; Freeman, A. P.; McLean, R. G.; Garvie.B. H.; Giles. R. W. Late cardiac, thyroid, and pulmonarysequellae of mantle radiotherapy for Hodkin’s disease.Int.J. Radiat. Oncol. Biol. Phys. 11:1925-1931: 1985.5. Polansky, S. M.; Ravin, C. E.; Prosnitz, L. R. Pulmonarychanges after primary radiation for early breastcarcinoma. Am. J. Radio]. 134:101-105; 1980.6. McGivern, D.; Bullimore, J.; Hill, J.: Davies, E. R.;Goodard, P. Diagnostic imaging of postirradiationchanges in the chest. Clin. Radiol. 39:109-l 19; 1988.321
7. Rubin, P. Radiation toxicity: Quantitative radiationpathology for predicting effects. Cancer 39(Suppl.2):729- 736; 1977.8. Bradley J, Thorstad WL, Mutic S, et al. Impact of FDG-PET on radiation therapy volume delineation in non–small-cell lung cancer. Int J Radiat Oncol Biol Phys2004;59:78–86,9. Daisne JF, Sibomana M, Bol A, et al. Tri-dimensionalautomatic segmentation of PET volumes based onmeasured source-to-background rations: influence ofreconstruction algorithms. Radiother Oncol2003;69:247–250.Suggested Reading:Br J Cancer. 2008 Jun 3;98(11):1870-5. Epub 2008May 27. LinksIncidence of interstitial pneumonitis among breast cancerpatients: a 10-year Danish population-based cohort study.Christensen S, Pedersen L, Grijota M, Kornum JB,Beiderbeck A, Sørensen HT.Department of Clinical Epidemiology, Aarhus UniversityHospital, Aarhus, Denmark. sc@dce.au.dkChemotherapy and radiation therapy may increase risk forinterstitial pneumonitis (IP) in breast cancer patients, but thereare little current population-based data on IP incidence in thesepatients. We assessed population-based incidence rates (IRs)of IP among Danish breast cancer patients and compared thesewith IRs for the Danish general population. Through the DanishCancer Registry, we identified all Danish breast cancer patients(n=35 823) diagnosed between 1994 and 2004. Treatment datawere obtained from the Danish Breast Cancer CooperationGroup database, and data on IP, from the Danish National322
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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
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Management of Facial Nerve InjuryIn
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2. Interposition or cable graft (to
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Prevention of corneal exposure Tars
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flushing) and localized sweating (g
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Other options :1. Intracutaneous in
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Shoulder Dysfunction or PainfulShou
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EMG studies on scapulo-humeral and
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Chyle Fistula after Neck Dissection
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Rationale:LCTs, which constitute 70
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CSF Leak after Craniofacial Resecti
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to the muscle to recreate the orbit
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Conservative treatmentIt is logical
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Complications Associated with use o
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Following is the example of hematol
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ooooooo direct interaction with the
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ooooointravenously over 15 minutes
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in most of the patients. The common
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Section — IIIRadiotherapyContribu
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nodes are involved or suspected to
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function. In general, with conventi
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like ultrasonography, CT scan, endo
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Page 281 and 282: Acute symptoms usually subside seve
Page 283 and 284: granulocytopenia, thrombocytopenia
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Page 287 and 288: patients who have received radical
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
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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 332 and 333: Registry of Patients. We computed I
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Page 336 and 337: Int J Radiat Oncol Biol Phys. 1995
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Page 340 and 341: Differential Diagnosis: This sign i
Page 342 and 343: Dose Incidence Comments Author>30 G
Page 344 and 345: PET scan findings have been describ
Page 346 and 347: 3. Pallis CA, Louis S, Morgan RL.:
Page 348 and 349: 24. Abbatucci JS, Delozier T, Quint
Page 350 and 351: and summarized into specific recomm
Page 352 and 353: adequate. With the increasing use o
Page 354 and 355: Complications are mainly described
Page 356 and 357: IQ decline is associated with sever
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Page 360 and 361: development after brain tumor thera
Page 362 and 363: Highest relative risk of second can
Page 364 and 365: Suggested Reading:A) Neuropsycholog
Page 366 and 367: aseline. Male sex, longer symptomat
Page 368 and 369: number of patients. Cognition was p
Page 370 and 371: 16 years, the corresponding value w
Page 372 and 373: 15 of 20 (75%) subjects, endocrine
Page 374 and 375: OBJECTIVE: To assess cerebrovascula
Page 376 and 377: hypometabolism. Of the 17 patients
Page 378: 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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