••• Chapter 49^ Radiation Therapy, Chemotherapy, Immunotherapy, and Tumor Markers^483
❍ What is the dose-limiting side effect associated with liposomal doxorubicin?
Palmar-plantar eryhrodysesthesia (hand-foot syndrome) is characterized by painful erythema and edema.
❍ Which antimetabolite is a nucleoside analog that can cause myelosuppression and fever as its side effects?
Gemcitabine.
❍ What agent has the most documented activity in metastatic sex cord tumors of the ovary?
Cisplatin. It is frequently used in combination with other agents.
❍ The combination of bleomycin, etoposide, and cisplatin (BEP) has been used successfully in what group of
female genital tumors?
Germ cell tumors of the ovary.
❍ Patients undergoing surgery after bleomycin treatment should avoid high-inhaled oxygen concentrations.
Why?
Acute pulmonary decompensation can occur.
❍ In the palliation of primary tumors, what percentage of a curative dose is typically used?
Relatively high doses, usually 75% to 80% of the curative dose.
❍ What determines the optimal dose of radiation that is used?
It is determined by the anatomic location, histologic type, stage and other characteristics of the tumor, and
relationship of the cancer to other proximal organs.
❍ What are the six major classes of antiemetics used for prevention and treatment of chemotherapy-induced
nausea and vomiting?
(1) Phenothiazines (Compazine).
(2) Gastrointestinal promotility agents (metoclopramide).
(3) Benzodiazepines (lorazepam).
(4) Steroids (dexamethasone).
(5) Serotonin inhibitors (ondansetron, granisetron).
(6) NK-1 receptor blocker (aprepitant/Emend).
❍ From the standpoint of cell burden, what represents a clinical tumor?
A clinical tumor can be considered to encompass several compartments.
(1) Macroscopic, visible, or palpable.
(2) Microextensions into adjacent tissues.
(3) Subclinical disease, presumed to be present but not detectable even with the microscope.
❍ What constitutes “gross tumor volume (GTV)”?
GTV is all known gross disease including enlarged regional lymph nodes.