••• Chapter 49^ Radiation Therapy, Chemotherapy, Immunotherapy, and Tumor Markers^481
❍ True or False: Dermatitis and nail loss are frequent toxicities of bleomycin.
True.
❍ What is the mechanism of action of actinomycin D?
It blocks RNA synthesis by intercalating DNA nucleotide pairs.
❍ What is “radiation recall”?
Skin erythema and irritation in a previously irradiated field following administration of chemotherapy. Adriamycin
and actinomycin D are commonly reported.
❍ For what phase of the cell cycle is cisplatin specific?
None, but it may be more effective in the S phase. The mechanism of action of cisplatin is poorly understood.
❍ Ifosfamide-induced hemorrhagic cystitis may be treated initially by?
Hydration and diuresis.
❍ If hemorrhagic cystitis persists despite hydration/diuresis, what is the most effective immediate topical
treatment?
Continuous bladder irrigation.
❍ The toxic metabolite of ifosfamide responsible for hemorrhagic cystitis is?
Acrolein. Mesna that is given before and after ifosfamide binds this product to prevent cystitis.
❍ What is the dose-limiting toxicity of carboplatin?
Myelosuppression. (Thrombocytopenia)
❍ For what phase of the cell cycle is paclitaxel specific?
M phase, since it is an antimitotic.
❍ Retreatment of ovarian cancer with a platinum drug may be appropriate for which patients?
Patients may be retreated with platinum if they have developed a recurrence at ≥6 months after cessation of their
last treatment (platinum sensitive).
❍ The use of a chemotherapeutic agent following definitive treatment of a tumor when a patient is clinically
disease free is known as?
Adjuvant therapy.
❍ Theoretical advantages of intraperitoneal administration of chemotherapy over intravenous administration
for ovarian cancer include?
High concentrations of the drug can be placed in immediate contact with the tumor for longer periods of time,
and toxicities may be lessened by liver metabolism as the drug is absorbed into the portal system.