ABSTRACT
PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 4 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 4 3. Compazine 10 mg PO/IV 30 minutes before chemotherapy
on days 1, 8, and 15
| OTHER MEDICATIONS
I Repeat every 21 days
1. Give cisplatin delayed-emesis prophylaxis
I Cisplatin-vigorous hydration is required; can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
Bleomycin-give test dose of 1-2 units because of possible acute pulmonary, anaphylactoid, or severe febrile reactions; must dose adjust for renal insufficiency; total lifetime dose should not exceed 400 units; avoid high Fi02 as it can exacerbate pulmo nary toxicity
Methotrexate-use 75% dose for CrCI < 50; 50% dose if CrCI < 25; do not give if patient has an effusion (“reservoir effect”)
Vincristine-vesicant-avoid extravasation; cumulative neurotox icity-may produce severe constipation; maximum 2 mg per administration
Carboplatin/ paclitaxel
I Paclitaxel 200 mg/M2 IV (over 3 h) dayl Carboplatin AUC 7 IV day 1
REF: Fountzilas et al. Ann Oncol 1997; 8:451-455
PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy 2. Diphenhydramine 50 mg IV 30 minutes before chemo
therapy 3. Cimetidine 300 mg IV 30 minutes before chemotherapy 4. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy
OTHER MEDICATIONS 1. Dexamethasone 4 mg PO BID for 6 doses after paclitaxel
(for myalgias) 2. G-CSF 5 mcg/kg/d SQ is given days 2-12 3. Give cisplatin delayed emesis prophylaxis
Repeat every 21 days CF cisplatin/ fiuorouracil (5-FU)
Cisplatin 100mg/M2 IV dayl 5-FU 1000 mg/M2/d CIV days 1-4
REF: Kish et al. Cancer 1984; 53:1819-1824
PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1
OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis
Repeat every 28 days
Cisplatin-vigorous hydration is required: can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
PF cisplatin fiuorouracil (5-FU)/ XRT larynx preservation
Cisplatin 100mg/M2 IV day 1 5-FU 1000 mg/M2/d CIV days 1-5 -followed by XRT to 6600-7600 cGy
REF: Veterans Affairs Laryngeal Cancer Study Group. NEJM 1991;324:1685-1690
PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1
OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis
Repeat every 28 days
Cisplatin-vigorous hydration is required; can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
PT cisplatin/ paclitaxel
Paclitaxel 200 mg/M2 IV (over 3 h) day 1 Cisplatin 75 mg/M2 IV day 1
REF: Hitt et al. Semin Oncol 1995; 22:50-54
PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy 2. Diphenhydramine 50 mg IV 30 minutes before chemo
therapy 3. Cimetidine 300 mg IV 30 minutes before chemotherapy 4. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy
OTHER MEDICATIONS 1. Dexamethasone 4 mg P0 BID for 6 doses after paclitaxel
(for myalgias) 2. Give cisplatin delayed-emesis prophylaxis 3. G-CSF 5 mcg/kg/d SO is given days 4-12
Repeat every 21-28 days
Cisplatin-vigorous hydration is required; can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine >1.5
TIP paclitaxel/ ifosfamide/ cisplatin
Paclitaxel 175 mg/M2 IV (over 3 h) dayl Ifosfamide 1000 mg/M2 IV (over 2 h) days 1-3 Mesna 600 mg/M2 IV days 1-3 Cisplatin 60 mg/M2 IV day 1
PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on days 1-3 2. Diphenhydramine 50 mg IV 30 minutes before chemo
therapy on day 1 3. Cimetidine 300 mg IV 30 minutes before chemotherapy on
day 1 4. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on days 1 -3
OTHER MEDICATIONS 1. Dexamethasone 4 mg PO BID for 6 doses after paclitaxel
(for myalgias) 2. Give cisplatin delayed-emesis prophylaxis
Repeat every 21-28 days
Cisplatin-vigorous hydration is required; can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
Ifosfamide-adequate hydration is necessary to prevent nephrotoxicity
VP vinorelbine/
Vinorelbine 25 mg/M2 IV days 1,8 Cisplatin 80 mg/M2 IV day 1
REF: Gebbia et al. Am J Clin Oncol 1995; 18:293-296
PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1
OTHER MEDICATIONS 1. Dexamethasone 4 mg PO BID for 6 doses after Paclitaxel
(for myalgias) 2. Give cisplatin delayed-emesis prophylaxis
Repeat every 21 days
Cisplatin-vigorous hydration is required; can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
Vinorelbine-vesicant; avoid extravasation; can cause peripheral neuropathy
cisplatin
Docetaxel ! Docetaxel 100 mg/M2 IV (over 1 h) dayl REF: Dreyfuss et al. J Clin Oncol 1996; 14:1672-1678
PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy 2. Cimetidine 300 mg IV 30 minutes before chemotherapy 3. Diphenhydramine 25-50 mg IV 30 minutes before
chemotherapy 4. Compazine 10 mg PO/IV 30 minutes before chemotherapy
j OTHER MEDICATIONS
1. Dexamethasone 8 mg PO BID for 8 doses-start day prior to chemo (decreases lower extremity edema)
Repeat every 21 days Methotrexate : Methotrexate 40 mg/M2 IV day 1
REF: Forastiere et al. J Clin Oncol 1992; 10:1245-1251
PREMEDICATIONS 1. Compazine 10 mg PO/IV 30 minutes before chemotherapy
j Repeat every 7 days
Methotrexate-use 75% dose for CrCI < 50; 50% dose if CrCI < 25; do not give if patient has an effusion (“reservoir effect”)
Paclitaxel : Paclitaxel 250 mg/M2 CIV (over 24 h) dayl i REF: Forastiere et al. Cancer 1998; 82:2270-2274
! PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy OR Dexamethasone 20 mg PO 6 and 12 hours prior to chemotherapy
2. Cimetidine 300 mg IV 30 minutes before chemotherapy 3. Diphenhydramine 25-50 mg IV 30 minutes before
chemotherapy 4. Compazine 10 mg PO/IV 30 minutes before chemotherapy
OTHER MEDICATIONS 1. Dexamethasone 4 mg PO BID for 6 doses after (for
myalgias) 2. Requires G-CSF support
Repeat every 21 days
