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Table 2 toxic reactions and prescribed management

From: Neoadjuvant chemoradiation followed by surgery versus surgery alone for patients with adenocarcinoma or squamous cell carcinoma of the esophagus (CROSS)

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

  1. CTC Common Toxicity Criteria