Radioterapi and chemotherapy plan


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Radioterapi and chemotherapy plan

  1. 1. Radioterapi and Chemotherapy plan A. Darah 1. Blood count : a. Leucosite b. Haemoglobin c. Thrombosite 2. Fungsi hati 3. Fungsi ginjal – creatinin clearence ( tampung urine 24 jam ) 4. Kadar Gula Darah Puasa dan 2 jam pp B. Foto 1. X ray foto Thorax 2. CT Scan Nasofaring C. Biopsi 1. Insisi biopsi tumor 2. Aspirasi biopsi kelenjar getah beningTherapyFollow-upFollow-up for patients includes the following: 1. Routine periodic examination of the original tumor site and neck. 2. CT or PET-CT scan. 3. MRI scan. 4. Blood work. 5. EBV titers. 6. Monitoring of patients should include the following: Surveillance of thyroid and pituitary function. Dental and oral hygiene. Jaw exercises to avoid trismus. 7. Evaluation of cranial nerve function, especially as it relates to vision and hearing.
  2. 2. 8. Evaluation of systemic complaints to identify distant metastasis.Although most recurrences occur within 5 years of diagnosis, relapse can be seen at longer intervals.The incidence of second primary malignancies is less than after treatment of tumors at other headand neck sites.[11]Poorly differentiated squamous cell cancer has been associated with EBV antibodies.[4,12] High-titerantibodies to virus capsid antigen and early antigen, especially of high IgA class, or high titers thatpersist after therapy, have been associated with a poorer prognosis.[13] This finding remains underevaluation.Tumors of many histologies can occur in the nasopharynx, but this discussion, like the American JointCommittee on Cancer nasopharynx staging, refers exclusively to WHO grade I-, II-, and III-typenasopharyngeal carcinoma.Routine staging procedures include:history, physical examination including cranial nerve examination, complete blood cell count, serumbiochemistry (including liver function test), chest X-ray, nasopharyngoscopy, computed tomography(CT) scan or magnetic resonance imaging (MRI) of nasopharynx and base of skull and neck. MRI ispreferred if available [III, B].Imaging for distant metastases including isotope bone scan and CT scan of chest and upperabdomen could be considered for at-risk subsets (node positive, especially N3 stage) and for thosepatients with clinical or biochemical abnormalities detected [III, B]. The use of positron emissiontomography is under investigation and findings seem promising.Both the pre-treatment and post-treatment plasma/serum load of Epstein–Barr viral DNA has beenshown to be of prognostic value [III, B].Nasopharyngeal cancer chemotherapy drugsThis page has information about the chemotherapy drugs used to treat cancer of the nasopharynx.There is information aboutThe drugs you may haveChemoradiation drugsHow you have chemotherapyThe drugs you may have
  3. 3. It is most common to have two or more chemotherapy drugs together to treat cancer. You may hearthis called combination chemotherapy. Using two or more drugs together is often more effectivethan using one drug. The main drugs used in the treatment of nasopharyngeal cancers areCisplatinFluorouracil (5-FU)EpirubicinOther chemotherapy drugs that have been used more recently for nasopharyngeal cancers includeDocetaxel (Taxotere)Paclitaxel (Taxol)These links will take you to information about the specific side effects of each drug.Chemoradiation drugsIf you have stage 3 or 4 nasopharyngeal cancer you are likely to have chemotherapy andradiotherapy at the same time (known as chemoradiation or synchronous treatment). Some peoplewith stage 2 nasopharyngeal cancer may also have this treatment. You may have one of thefollowingCisplatinCisplatin and 5FUCarboplatinPaclitaxel (Taxol)Docetaxel (Taxotere)Some of this treatment is experimental and you may have it as part of a clinical trial. Doctors use theresults from clinical trials to improve treatment for head and neck cancers in the future. There isinformation about the side effects of chemoradiation on the next page in this section.How you have chemotherapyYou usually have chemotherapy as cycles of treatment. You have these drugs through a drip(intravenous infusion) into your arm, usually once every 3 or 4 weeks. Or you may have the drugsthrough a tube going into your chest called a central line or portacath. Each 3 or 4 week period isknown as one cycle of treatment. You will probably have between 3 and 4 cycles to begin with. If thetreatment is working and you’re not having too many side effects you will probably go on to have upto 6 cycles. Your own doctor will decide the exact amount and number of treatments you have. Sothe complete chemotherapy course can take 6 months or more.Sumber
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