Guidelines for Complications of Cancer Treatment Vol VIII Part B

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Vincristine: No dose reduction if bilirubin < 1.5 mg/dL andSGOT < 60 mg/dL.Reduce by 50% if bilirubin 1.5–3.0 mg/dL and SGOT 60–180 mg/dL. Omit if bilirubin > 3.0 mg/dL or SGOT > 180mg/dL.N/A– not available. ULN– upper limit of normal.Bibliography1. Ishak KG, Zimmerman HJ. Morphologic spectrums ofdrug-induced liver disease. Gastroenterol Clin North Am1995;24:759-786.2. Lee WM. Drug-induced hepatotoxicity. N Engl J Med1995; 333: 1118-1127.3. Goldberg JW, Lidsky MD. Cyclophosphamideassociated hepatotoxicity. South Med J 1985; 78:222-223.4. Rodriquez V, Bodey GP, Freireich EJ, et al. Reductionof ifosfamide toxicity using dose fractionation. CancerRes 1976; 36:2945-2948.5. Lazarus HM, Herzig RH, Graham Pole J, et al. Intensivemelphalan chemotherapy and cryopreserved autologousbone marrow transplantation in the treatment ofrefractory cancer. J Clin Oncol 1983; 1:359-367.6. Morris LE, Guthrie TH. Busulfan induced hepatitis. AmJ Gastroenterol 1988;83: 682-683.7. Stephen C. Medlin Michael C. Perry. In Michael C. Perryeds. Chemotherapy Source Book, 4th Edition ,Lippincott Williams & Wilkins 2008 : 212- 213.8. RE Slavin, MA Dias and R Saral, Cytosine arabinosideinduced gastrointestinal toxic alterations in sequentialchemotherapeutic protocols: a clinical-pathologic studyof 33 patients, Cancer 42 (1978), pp. 1747–1759.469
9. Spriggs DR, Stopa E, Mayer RJ, et al. Fludarabinephosphate (NSC312878) infusions for the treatment ofacute leukemia: phase I and neuropathological study.Cancer Res 1986; 46:5953-5958.10. CG Moertel, TR Fleming, JS Macdonald, DG Hallerand JA Laurie, Hepatic toxicity associated withfluorouracil plus levamisole adjuvant therapy, J ClinOncol 11 (1993), pp. 2386–2390.11. Product information: xeloda(R), capecitabine. Nutley:Roche Pharmaceuticals, 2001, 2001d.12. Robinson K, Lambiase L, Jianjun L, et al. Fatalcholestatic liver failure associated with gemcitabinetherapy. Dig Dis Sci 2003; 148:1804-1808.13. Berkowitz RS, Goldstein DP, Bernstein MR. Ten year’sexperience with methotrexate and folinic acid as primarytherapy for gestational trophoblastic disease. GynecolOncol 1986; 23:111-118.14. RS Berkowitz, DP Goldstein and MR Bernstein, Tenyear’s experience with methotrexate and folinic acid asprimary therapy for gestational trophoblastic disease,Gynecol Oncol 23 (1986), pp. 111–118.15. Blum RH, Carter SK, Agre K. A clinical review ofbleomycin. A new antineoplastic agent. Cancer 1973;31:903-914.16. Venook A, Egorin M, Brown TD, et al. Paclitaxel (Taxol)in patients with liver dysfunction [Abstract]. Proc AmerSoc Clin Oncol 1994; 350:139.17. Issell BF, Crooke ST. Etoposide (VP-213). Cancer TreatRev 1979; 6:107-124.18. Johnson DH, Greco FA, Wolff SN. Etoposide-inducedhepatic injury: a potential complication of high-dosetherapy. Cancer Treat Rep 1983; 67:1023-1024.470
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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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catheter passed through the anus in
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Acute symptoms usually subside seve
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granulocytopenia, thrombocytopenia
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adiation therapy), IMRT (intensity-
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patients who have received radical
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ate expected in the standard popula
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adjusting for competing causes of d
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therapy (3D-CRT) and intensity modu
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attributed to use of cisplatin base
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Conclusion:Incidence of SMN is incr
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11. Travis LB, Fossa SD, Schonfeld
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adiation-related solid SMNs will in
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0.71, p
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5.65%) within 45 years after a CNS
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adiation damage though supporting v
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without calcification. Inflammation
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patients treated using the original
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incidence of valvular thickening at
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12. Hancock S, Hoppe R. Long-term c
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syndrome and bronchiolitis oblitera
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Darby SC, McGale P, Taylor CW, Peto
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undertaken, based on individual pat
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Pathophysiological Aspects:The func
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Symptoms: Symptoms related to pulmo
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Prevention of Pneumonitis and Lung
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genotyping analysis of single nucle
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Registry of Patients. We computed I
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eceived elective nodal irradiation
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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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Page 430 and 431: The relative risk of developing TLS
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Page 440 and 441: Table 2. Cairo-Bishop clinical Tumo
Page 442 and 443: Table 4 Patient Stratification by R
Page 444 and 445: Table 6 Management of Electrolyte A
Page 446 and 447: of TLS and improve the management o
Page 448 and 449: 4. Efficacy and safety of rasburica
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Page 452 and 453: Though there are many chemotherapeu
Page 454 and 455: corticosteroids with variable respo
Page 456 and 457: Nephrotoxicity ofChemotherapeutic D
Page 458 and 459: associated with use of carbopltin c
Page 460 and 461: Table 2 Chemotherapeutics Requiring
Page 462 and 463: against ifosfamide nephrotoxicity.
Page 464 and 465: The incidence of mucositis involvin
Page 466 and 467: 7. Obesity - Probably due to over d
Page 468 and 469: conditioning treatment and for 3 da
Page 470 and 471: References and Recommended Readings
Page 472 and 473: metabolism for activity, cyclophosp
Page 474 and 475: delays excretion and eventually res
Page 476 and 477: Combination Chemotherapy:Combinatio
Page 480 and 481: 19. Slichenmyer WJ, Rowinsky EK, Gr
Page 482 and 483: AlopeciaCommon drugs causing alopec
Page 484 and 485: dependent, occurring from 8 days to
Page 486 and 487: Cancer Induced Anemia (CIA)Introduc
Page 488 and 489: system. There is an upregulation of
Page 490 and 491: time may represent increasing anemi
Page 492 and 493: (rHuEPO) whiles the other received
Page 494 and 495: Table 3. Improvements in Hemoglobin
Page 496 and 497: 2. Groopman JE, Itri LM. Chemothera
Page 498 and 499: epoetin alfa versus oral iron or no
Page 500 and 501: NOTES
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