RESUMEN
In this brief report we have described eight children affected by optic pathway/hypothalamus gliomas and treated with carboplatin and/or cisplatin, which developed a derangement of sodium and water metabolism, due to diabetes insipidus (DI) or to syndrome of inappropriate antidiuretic hormone secretion (SIADH) after surgical resection. In four out of these eight patients the treatment with platinum compounds produced prolonged haematological toxicity and in five out of them it caused neurosensorial bilateral hypoacusia. In addition cisplatin worsened electrolytes disturbances. Hence children with DI or SIADH should be carefully monitored before, during and after the treatment with platinum compounds.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias Encefálicas/tratamiento farmacológico , Diabetes Insípida/etiología , Glioma/tratamiento farmacológico , Síndrome de Secreción Inadecuada de ADH/etiología , Sodio/metabolismo , Desequilibrio Hidroelectrolítico/inducido químicamente , Adolescente , Neoplasias Encefálicas/metabolismo , Carboplatino/administración & dosificación , Preescolar , Cisplatino/administración & dosificación , Femenino , Estudios de Seguimiento , Glioma/metabolismo , Humanos , Neoplasias Hipotalámicas/tratamiento farmacológico , Neoplasias Hipotalámicas/metabolismo , Lactante , Masculino , Procedimientos Neuroquirúrgicos/efectos adversos , Neoplasias del Nervio Óptico/tratamiento farmacológico , Neoplasias del Nervio Óptico/metabolismo , PronósticoRESUMEN
Errors involving patients receiving intrathecal chemotherapy are a significant problem in oncology. Despite the improvement in the management of antineoplastic agents, unintentional intrathecal administration of chemotherapic drugs that are indicated only for systemic administration or intrathecal overdose of drugs regularly used for intrathecal chemotherapy, continue to occur. These events can result in severe neurotoxicity, usually fatal in outcome. We review reported cases of medication errors in intrathecal administration of chemotherapy described in the literature. Diverse rescue therapies have been proposed but the most effective means of managing these errors remains prevention.
Asunto(s)
Antineoplásicos/administración & dosificación , Errores de Medicación , Antraciclinas/administración & dosificación , Sobredosis de Droga , Humanos , Inyecciones Espinales , Alcaloides de la Vinca/administración & dosificaciónRESUMEN
Irinotecan is a promising anticancer agent for the treatment of childhood cancer unresponsive to conventional chemotherapy. Its active metabolite, 7-ethyl-10 hydroxycamptothecin (SN-38) is glucuronidated by a uridine-diphosphoglucuronosyltransferase (UGT1A1) to form an inactive metabolite. It was supposed that patients with the UGT1A1*28 polymorphism would have a greater prevalence of elevated pretreatment serum bilirubin levels and higher toxicity. The aim of our study was to investigate the predictive value of pre-treatment bilirubin levels in the development of severe diarrhea in solid tumor patients treated with irinotecan. The survey included 14 pediatric patients with refractory sarcomas treated with irinotecan (CPT-11). Patients were grouped based on the development of mild (G0-2) or severe (G3) gastrointestinal toxicity. The simple linear regression model and the non-parametric paired wilcoxon test were adopted for the analysis. p <0.05 was judged to indicate a significant difference. The results showed a significant increase in severity of diarrhea with increasing total pre-treatment bilirubin. therefore, we propose that pre-treatment bilirubin levels can predict gastrointestinal toxicity in pediatric cancer.