Reaction | Management of reactions |
---|---|
Renal: | Â |
   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: | Â |
   Mucositis with oral ulcers or protracted vomiting despite antiemetic premedication | Delay chemotherapy one week |
Neurologic: | Â |
   CTC grade ≤ 2 | Continue therapy |
   CTC grade > 2 | Stop chemotherapy |
Cardiac: | Â |
   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 |