Administration

• Involved field radiotherapy is given in week 6, 2 weeks after last dose of chemotherapy. The dose is 30-40Gy to the initial volume of the disease.

• Outpatient treatment.

• Consider sperm banking in males (low risk of infertility).

• Oral systemic PCP prophylaxis is recommended for the first 6 weeks.

• Oral systemic antifungal prophylaxis is optional.

• Antiemetic therapy for moderately emetogenic regimens on days 1 and 15.

• Delay doxorubicin, cyclophosphamide or etoposide by 1 week if platelets <100 x 109/L or neutrophils <1 x 109/L.

• Reduce cyclophosphamide to 75% dose if creatinine clearance 10-50mL/min, 50% dose if creatinine clearance <10mL/min.

• Reduce doxorubicin, vincristine and etoposide to 50% dose if serum bilirubin 1.7-2.5 x upper limit normal and 25% if 2.5-4 x upper limit normal. Caution with cyclophosphamide if hepatic impairment.

0 0

Post a comment