ONS Chemotherapy Course Questions
and answers
neoadjuvant chemotherapy - ANSWER-Chemotherapy given before primary
therapy (surgery or radiation) to reduce the size of a solid tumor
adjuvant chemotherapy - ANSWER-Chemotherapy given after primary therapy
(surgery or radiation)
Induction - ANSWER-For Hematological Malignancies: initial phase of
chemotherapy, initiated in a hospital setting due to risk of serious side
effects/complications from ensuing myelosupression. Goal is to achieve a
complete response.
Consolidation - ANSWER-For Hematological Malignancies: Once induction is
complete, response is monitored via CBC and bone marrow biopsy.
Consolidation is done to ensure treatment takes effect, and decrease chance of
re-occurrence.
myeloablation - ANSWER-For Hematological Malignancies: Procedure involving
the elimination of the hematopoietic system, including its components residing in
the bone marrow, often achieved through the application of a toxic drug and
whole-body radiation. Done prior to stem cell or BMT.
Alkylating agents - ANSWER-cell cycle nonspecific, exert effect in all phases of
cell cycle. Cause breaks in DNA via alkylation, interfering with DNA replication.
Carboplatin, cisplatin, ifosfamide, cyclophosphamide.
Cyclophosphamide (Cytoxan) - ANSWER-Alkylating agent
Routes: IV, PO, intraperitoneal.
, Highly emetogenic, acute hemmorhagic cystitis may occur: Mesna and bladder
irrigation may be needed, provide IV hydration pre/post treatment to prevent
cystitis. Encourage PO Fluids up to 2 L per day with PO doses.
Cisplatin (Platinol) - ANSWER-Alkylating agent
Routes: IV, intraperitoneal
Severe emetogenic, have anti-emetic regimen ready.
Acute renal failure can occur, vigourous hydration needed, forced diuresis
sometimes used, avoid nephrotoxic agents
* A urine output of 100 mL/hour or greater will tend to minimize cisplatin
nephrotoxicity. This can be accomplished by prehydration with 2 litres of an
appropriate intravenous solution, and similar post cisplatin hydration
(recommended 2,500 mL/m2/24 hours). If vigorous hydration is insufficient to
maintain adequate urinary output, an osmotic diuretic may be administered (eg,
mannitol).
Cisplatin reacts with metallic aluminium to form a black precipitate of platinum. All
aluminium containing IV sets, needles, catheters and syringes should be
avoided.
Peirpheral Neuropathies and Ototoxicity (hearing loss) may occur with high dose
or prolonged therapy
Magnesium and Potassium supplementation may be neccessary
The most frequently reported adverse events (>10%) of cisplatin were
haematological (leukopenia, thrombocytopenia and anaemia), gastrointestinal
(anorexia, nausea, vomiting and diarrhoea), ear disorders (hearing impairment),
renal disorders (renal failure, nephrotoxicity, hyperuricemia) and fever.
Carboplatin (Paraplatin) - ANSWER-alkylating agent
Routes : IV
and answers
neoadjuvant chemotherapy - ANSWER-Chemotherapy given before primary
therapy (surgery or radiation) to reduce the size of a solid tumor
adjuvant chemotherapy - ANSWER-Chemotherapy given after primary therapy
(surgery or radiation)
Induction - ANSWER-For Hematological Malignancies: initial phase of
chemotherapy, initiated in a hospital setting due to risk of serious side
effects/complications from ensuing myelosupression. Goal is to achieve a
complete response.
Consolidation - ANSWER-For Hematological Malignancies: Once induction is
complete, response is monitored via CBC and bone marrow biopsy.
Consolidation is done to ensure treatment takes effect, and decrease chance of
re-occurrence.
myeloablation - ANSWER-For Hematological Malignancies: Procedure involving
the elimination of the hematopoietic system, including its components residing in
the bone marrow, often achieved through the application of a toxic drug and
whole-body radiation. Done prior to stem cell or BMT.
Alkylating agents - ANSWER-cell cycle nonspecific, exert effect in all phases of
cell cycle. Cause breaks in DNA via alkylation, interfering with DNA replication.
Carboplatin, cisplatin, ifosfamide, cyclophosphamide.
Cyclophosphamide (Cytoxan) - ANSWER-Alkylating agent
Routes: IV, PO, intraperitoneal.
, Highly emetogenic, acute hemmorhagic cystitis may occur: Mesna and bladder
irrigation may be needed, provide IV hydration pre/post treatment to prevent
cystitis. Encourage PO Fluids up to 2 L per day with PO doses.
Cisplatin (Platinol) - ANSWER-Alkylating agent
Routes: IV, intraperitoneal
Severe emetogenic, have anti-emetic regimen ready.
Acute renal failure can occur, vigourous hydration needed, forced diuresis
sometimes used, avoid nephrotoxic agents
* A urine output of 100 mL/hour or greater will tend to minimize cisplatin
nephrotoxicity. This can be accomplished by prehydration with 2 litres of an
appropriate intravenous solution, and similar post cisplatin hydration
(recommended 2,500 mL/m2/24 hours). If vigorous hydration is insufficient to
maintain adequate urinary output, an osmotic diuretic may be administered (eg,
mannitol).
Cisplatin reacts with metallic aluminium to form a black precipitate of platinum. All
aluminium containing IV sets, needles, catheters and syringes should be
avoided.
Peirpheral Neuropathies and Ototoxicity (hearing loss) may occur with high dose
or prolonged therapy
Magnesium and Potassium supplementation may be neccessary
The most frequently reported adverse events (>10%) of cisplatin were
haematological (leukopenia, thrombocytopenia and anaemia), gastrointestinal
(anorexia, nausea, vomiting and diarrhoea), ear disorders (hearing impairment),
renal disorders (renal failure, nephrotoxicity, hyperuricemia) and fever.
Carboplatin (Paraplatin) - ANSWER-alkylating agent
Routes : IV
