Chapter 49
477
Radiation Therapy,
Chemotherapy,
Immunotherapy, and
Tumor Markers
Mitchell I. Edelson, MD
❍ What is the dose-limiting toxicity associated with cisplatin?
Peripheral neuropathy. This is also the most common side effect usually involving the hands and feet.
❍ True or False: Anticancer drugs can kill a fixed number of tumor cells per dose.
False. Anticancer drugs kill a fixed percentage of tumor cells per dose.
❍ What is the mechanism of action of methotrexate?
Methotrexate binds dihydrofolate reductase, preventing reduction in folate to tetrahydrofolate, which is necessary
for production of thymidine and purines.
❍ What side effects are seen with the use of serotonin antagonists (ondansetron/Zofran, granisetron/Kytril,
dolasetron/Anzemet) as antiemetics?
Headache and constipation.
❍ What is the maximum total cumulative dose of Adriamycin suggested to minimize the risk of
cardiomyopathy?
<500 mg/m^2.
❍ What immediate steps should be taken to minimize tissue damage following extravasation of Adriamycin?
Stop the infusion, aspirate the drug from the site if possible, apply ice to the affected area, and apply Dimethyl
sulfoxide (DMSO) topically and allow to air dry.
❍ While cold packs are recommended for the treatment of most extravasation injuries, with which class of
chemotherapy agent should warm soaks be utilized?
Vinca alkaloids such as vincristine and etoposide.