Nasopharyngeal carcinoma medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*Pharmacologic medical therapies for nasopharyngeal carcinoma include Cisplatin and 5-Fluorouracil. | *[[Pharmacologic]] [[medical]] therapies for nasopharyngeal carcinoma include [[Cisplatin]] and 5-[[Fluorouracil (injection)|Fluorouracil]]. | ||
* '''Cisplatin:''' | * '''Cisplatin:''' | ||
** Preferred regimen: 80- 100 mg/m<sup>2</sup> slow IV with enough hydration.Repeat every 3 weeks | ** Preferred regimen: 80-100 mg/m<sup>2</sup> slow [[Intravenous therapy|IV]] with enough [[hydration]]. Repeat every 3 weeks. | ||
** Contraindications: | ** [[Contraindications]]: | ||
*** Hypersensitivity to platinum-containing compounds | *** [[Hypersensitivity]] to [[platinum]]-containing compounds | ||
*** Renal function impairment | *** [[Renal function impairment]] | ||
*** Hearing impairment | *** [[Hearing impairment]] | ||
*** Myelosuppressed patients | *** Myelosuppressed [[patients]] | ||
*** Nursing or pregnant women | *** Nursing or [[pregnant]] women | ||
** Side effects: | ** [[Adverse effect (medicine)|Side effects]]: | ||
*** Nephrotoxicity | *** [[Nephrotoxicity]] | ||
*** Ototoxicity | *** [[Ototoxicity]] | ||
*** Myelosuppression | *** [[Myelosuppression]] | ||
*** Gastrointestinal problems like acute and delayed nausea and vomiting and diarrhea | *** [[Gastrointestinal]] problems like [[Acute (medicine)|acute]] and delayed [[nausea and vomiting]] and [[diarrhea]] | ||
*** Electrolyte disturbance: | *** [[Electrolyte disturbance]]: | ||
**** [[Hypomagnesemia]] | **** [[Hypomagnesemia]] | ||
**** [[Hypocalcemia]] | **** [[Hypocalcemia]] | ||
| Line 69: | Line 69: | ||
**** [[Hypokalemia]] | **** [[Hypokalemia]] | ||
**** [[Hypophosphatemia]] | **** [[Hypophosphatemia]] | ||
*** Irreversible paresthesias | *** [[Irreversible]] [[paresthesias]] | ||
*** Anaphylaxis | *** [[Anaphylaxis]] | ||
'''Note (1):''' Urine output should be maintain more than 100-150 ml/ hr. | '''Note (1):''' [[Urine output]] should be maintain more than 100-150 ml/ hr. | ||
'''Note (2):''' Anti-emetic treatment should be done in all patients. | '''Note (2):''' [[Antiemetic|Anti-emetic]] treatment should be done in all [[patients]]. | ||
* '''5-Fluorouracil:''' | * '''5-[[Fluorouracil]]:''' | ||
** Preferred regimen: 1000 mg/m<sup>2</sup>/day IV infusion for 4-5 days and repeated every 3 weeks. | ** Preferred regimen: 1000 mg/m<sup>2</sup>/day [[Intravenous therapy|IV]] [[infusion]] for 4-5 days and repeated every 3 weeks. | ||
** Contraindications: | ** [[Contraindications]]: | ||
*** Hypersensitivity | *** [[Hypersensitivity]] | ||
*** Liver diseases | *** [[Liver diseases]] | ||
*** Renal function impairment | *** [[Renal function impairment]] | ||
*** Myelosuppressed patients | *** Myelosuppressed patients | ||
*** | *** [[Unstable angina]] | ||
** [[Adverse effect (medicine)|Side effects]]: | |||
** Side effects: | *** [[Myelosuppression]] | ||
*** Myelosuppression | *** [[Gastrointestinal]] problems like [[nausea and vomiting]] and [[diarrhea]] | ||
*** Gastrointestinal problems like nausea and vomiting and diarrhea | *** [[Mucositis]] | ||
*** Mucositis | *** [[Angina]] | ||
*** Angina | |||
*** Alopecia | *** Alopecia | ||
*** Hand-foot syndrome | *** [[Hand-foot syndrome]] | ||
'''Note (1):''' In [[patients]] with [[liver diseases]] [[dose]] reduction should be considered. | |||
'''Note (2):''' Using this drug in familial pyrimidenemia [[patients]] can cause fatal [[neurotoxicity]]. | |||
'''Note ( | |||
** | ** | ||
==References== | ==References== | ||
Revision as of 18:04, 18 March 2019
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Nasopharyngeal carcinoma Microchapters |
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Differentiating Nasopharyngeal carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Nasopharyngeal carcinoma medical therapy On the Web |
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American Roentgen Ray Society Images of Nasopharyngeal carcinoma medical therapy |
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Risk calculators and risk factors for Nasopharyngeal carcinoma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]Faizan Sheraz, M.D. [3]
Overview
The mainstay of therapy for nasopharyngeal carcinoma is external beam radiotherapy, supplemented in some cases with chemotherapy.
Medical Therapy
The mainstay of therapy for nasopharyngeal carcinoma is external beam radiotherapy.
- Standard treatments for patients with nasopharyngeal carcinoma include:[1]
- External beam radiation therapy alone
- Concurrent chemoradiation followed by adjuvant chemotherapy
- Chemotherapy alone for metastatic disease
- Undifferentiated subtype of nasopharyngeal carcinoma is highly radiosensitive
Treatment according to Stages
| Stage | Treatment |
|---|---|
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Stage 1 |
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Stage 2 |
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Stage 3 |
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Stage 4 |
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Medical Therapy
- Pharmacologic medical therapies for nasopharyngeal carcinoma include Cisplatin and 5-Fluorouracil.
- Cisplatin:
- Preferred regimen: 80-100 mg/m2 slow IV with enough hydration. Repeat every 3 weeks.
- Contraindications:
- Hypersensitivity to platinum-containing compounds
- Renal function impairment
- Hearing impairment
- Myelosuppressed patients
- Nursing or pregnant women
- Side effects:
Note (1): Urine output should be maintain more than 100-150 ml/ hr.
Note (2): Anti-emetic treatment should be done in all patients.
- 5-Fluorouracil:
- Preferred regimen: 1000 mg/m2/day IV infusion for 4-5 days and repeated every 3 weeks.
- Contraindications:
- Hypersensitivity
- Liver diseases
- Renal function impairment
- Myelosuppressed patients
- Unstable angina
- Side effects:
- Myelosuppression
- Gastrointestinal problems like nausea and vomiting and diarrhea
- Mucositis
- Angina
- Alopecia
- Hand-foot syndrome
Note (1): In patients with liver diseases dose reduction should be considered.
Note (2): Using this drug in familial pyrimidenemia patients can cause fatal neurotoxicity.