Table 2

toxic reactions and prescribed management

Reaction

Management of reactions


Renal:

Creatinin ≤ 1.5 × upper limit of normal at day of treatment

Continue treatment

Creatinin > 1.5 × upper limit of normal

Establish intravenous infusion the evening preciding treatment at a rate to correct any volume deficits and produce a urine flow ≥ ml/h. Repeat serum creatinin value in the morning:

≤ 1.5 × upper limit of normal → proceed treatment

> 1.5 × upper limit of normal → stop chemotherapy


Gastrointestinal:

Mucositis with oral ulcers or protracted vomiting despite antiemetic premedication

Delay chemotherapy one week


Neurologic:

CTC grade ≤ 2

Continue therapy

CTC grade > 2

Stop chemotherapy


Cardiac:

Asympotomatic bradycardia or isolated asymptomatic ventricular extrasystoles

Continue therapy under continuous cardiac monitoring

First degree AV block

Continue therapy under continuous cardiac monitoring

Symptomatic arrhythmia or AV block (except 1st degree) or other heart blocks

Stop chemotherapy, manage arrhythmia according to standard practice; patient goes off protocol


CTC Common Toxicity Criteria

van Heijl et al. BMC Surgery 2008 8:21   doi:10.1186/1471-2482-8-21

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