Guidelines for Complications of Cancer Treatment Vol VIII Part B

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and exercise, have been shown to be effective therapies forlymphedema, but the effect of pharmacologic interventionsremains uncertain. Comparing results across studies iscomplicated by the fact that the definitions of interventionsand measures of outcomes and risk stratification varysubstantially among studies. As arm edema becomes moreprevalent with the increasing survival of breast cancer patients,further research is needed to evaluate the efficacy of preventivestrategies and therapeutic interventions.PMID: 11208879 [PubMed - indexed for MEDLINE]33. Complications of level I and II axillary dissectionin the treatment of carcinoma of the breast.Roses DF, Brooks AD, Harris MN, et al. Ann Surg. 1999Aug;230(2):194-201.OBJECTIVE: To assess the complications of level I and IIaxillary lymph node dissection in the treatment of stage I andII breast cancer, with breast-conservation surgery andmastectomy. SUMMARY BACKGROUND DATA: The roleof axillary dissection for staging, and as an effective means ofcontrolling regional nodal disease, has long been recognized.As small and low-grade lesions have been detected morefrequently, and as its therapeutic impact has been questioned,axillary dissection has increasingly been perceived asassociated with significant complications. METHODS: Twohundred patients, 112 of whom had breast-conservation surgerywith axillary dissection and 88 of whom had total mastectomywith axillary dissection, were evaluated 1 year or more aftersurgery for arm swelling as well as nonedema complications.All patients had arm circumference measurements at the samefour sites on both the operated and nonoperated sides.RESULTS: No patient had an axillary recurrence. The meandifference in circumference on the nonoperated versusoperated side was 0.425 cm +/- 1.39 at the midbiceps (p
0.001), 0.315 cm +/- 1.27 at the antecubital fossa (p < 0.001),0.355 cm +/- 1.53 at the midforearm (p < 0.005), and 0.055cm +/- 0.75 at the wrist (n.s.). Seven patients (3.5%) had mildswelling of the hand. Heavy and obese body habitus were theonly significant predictors of edema on multivariate analysis.One hundred fifty-three (76.5%) patients had numbness orparesthesias of the medial arm and/or axilla after surgery; in125 (82%) of these, the problem had lessened or had resolvedon follow-up assessment. CONCLUSIONS: Thecharacterization of a level I and II axillary dissection as aprocedure with significant complications does not appearjustified based on this experience.PMCID: PMC1420861PMID: 10450733 [PubMed - indexed for MEDLINE]40
Page 1 and 2: Guidelines forComplications ofCance
Page 3: Dedicated toAll our patients atThe
Page 6 and 7: Section IIHead & Neck 151Complicati
Page 8 and 9: PrefaceTreatment of cancer by vario
Page 10: Section — IGeneralContributorsDr.
Page 13 and 14: 6. Complications after breast recon
Page 15 and 16: promises to reduce this risk of ser
Page 17 and 18: preceded by increased sensory hyper
Page 19 and 20: had significant lymphoedema. The fa
Page 21 and 22: 2. Smoking as a risk factor for wou
Page 23 and 24: 4. Preoperative core needle biopsy
Page 25 and 26: eduction mammoplasty, and axillary-
Page 27 and 28: postoperative wound infection follo
Page 29 and 30: ablative surgical treatment for car
Page 31 and 32: postoperative seroma formation usin
Page 33 and 34: dressing consisted of a circumferen
Page 35 and 36: mastectomies with axillary node cle
Page 37 and 38: mastectomy for breast cancer. Early
Page 39 and 40: monitored for the development of po
Page 41 and 42: modality, and tumor stage distribut
Page 43 and 44: 26. Pain and other symptoms during
Page 45 and 46: 28. Coping, catastrophizing and chr
Page 47: surgical technique at the time of m
Page 51 and 52: or heat and superficial incision is
Page 53 and 54: RecommendationsA. Preparation of th
Page 55 and 56: 3. Mangram AJ, Horan TC, Pearson ML
Page 57 and 58: Mild hypothermia increases blood lo
Page 59 and 60: Perioperative Normothermia to Reduc
Page 61 and 62: Priorities: Restoration of circulat
Page 63 and 64: than 1.5 times control values but f
Page 65 and 66: outcomes that may result from the u
Page 67 and 68: Preoperative Preparation of the Pat
Page 69 and 70: patients, or other patients who may
Page 71 and 72: Obstruction can occur at the level
Page 74 and 75: c. Administer face mask preoxygenat
Page 76 and 77: 5. The use of exhaled carbon dioxid
Page 78 and 79: disorder) may occur after an episod
Page 80 and 81: undergoing general anesthesia, eith
Page 82 and 83: anesthesia awareness occurred in ea
Page 84 and 85: The current guidelines are actually
Page 86 and 87: o S - Strong Recommendation -Commit
Page 88 and 89: oSource control ASAP after successf
Page 90 and 91: oooWean steroids once vasopressors
Page 92 and 93: Mechanical ventilation of sepsis-in
Page 94 and 95: o CVVH offers easier management inh
Page 96 and 97: critically ill patient that are con
Page 98 and 99:
Rivers E, Nguyen B, Havstad S, et a
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in survival of 7.6%. By the second
Page 102 and 103:
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
Page 158:
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
Page 182 and 183:
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
Page 200 and 201:
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
Page 206 and 207:
anatomy as related to surgery of th
Page 208 and 209:
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
Page 240 and 241:
Prevention of corneal exposure Tars
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flushing) and localized sweating (g
Page 244 and 245:
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
Page 262 and 263:
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
Page 294 and 295:
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
Page 310 and 311:
without calcification. Inflammation
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patients treated using the original
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incidence of valvular thickening at
Page 316 and 317:
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
Page 322 and 323:
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
Page 334 and 335:
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
Page 344 and 345:
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
Page 354 and 355:
Complications are mainly described
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IQ decline is associated with sever
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activity’ of a person, essentiall
Page 360 and 361:
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
Page 372 and 373:
15 of 20 (75%) subjects, endocrine
Page 374 and 375:
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
Page 386 and 387:
Known colonization with Penicillin/
Page 388 and 389:
DocumentedinfectionsSuggesteddurati
Page 390 and 391:
Zygomycosis and other mold infectio
Page 392 and 393:
Overall risk Examples Febrile neutr
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Broad spectrum DOSE Spectrum Commen
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Page 398 and 399:
Page 400 and 401:
Role of G-CSF-Primary Prophylaxis:R
Page 402 and 403:
Chemotherapy Induced Nausea andVomi
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Level I Level II Level III Level IV
Page 406 and 407:
Types & doses of AntiemeticsDrug &
Page 408 and 409:
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
Page 416 and 417:
Late Effects in Childhood CancerSur
Page 418 and 419:
to increase their awareness about l
Page 420 and 421:
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
Page 430 and 431:
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
Page 436 and 437:
hydration, and the administration o
Page 438 and 439:
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
Page 444 and 445:
Table 6 Management of Electrolyte A
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of TLS and improve the management o
Page 448 and 449:
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
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 478 and 479:
Vincristine: No dose reduction if b
Page 480 and 481:
19. Slichenmyer WJ, Rowinsky EK, Gr
Page 482 and 483:
AlopeciaCommon drugs causing alopec
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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
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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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