Therapy Intro

Question 1

Define adjuvant treatment.

Answer 1

Systemic chemotherapy after localized treatment (surgery, radiation); curative intent

Question 2

Define neo-adjuvant treatment.

Answer 2

Systemic chemotherapy before localized treatment; to shrink tumor (easier to resect, easier to irradiate)

Question 3

Define palliative treatment.

Answer 3

Minimize symptoms of disease by shrinking tumor or delay worsening of symptoms; not expecting to cure, just prolong life and maintain QOL

Question 4

Contrast the use of chemotherapy in the adjuvant and palliative settings.

Answer 4

Chemotherapy is intended for curative purposes in adjuvant; chemo is meant to prolong life and maintain QOL in palliative, know that won’t be cured

Question 5

Describe the origins of using BSA for dosing chemotherapy.

Answer 5

Originally used as a treatment for children with leukemia (?). Kids’ dosing is based off of BSA. Once therapy was moved to adults as well, kept using BSA as the basis for dosing because knew it worked. Likely not the best way to dose, but it works!

Question 6

Differentiate a cancer grade vs. a cancer stage.

Answer 6

• Grade = describes the appearance of the cancerous cells; aggressiveness = poorly differentiated; grade 1 (well differentiated, more indolent, slower growing), grade 3 (poorly differentiated, more aggressive)
• Staging = describes size of the tumor; cancer specific; tumor, node, metastasis (TMN) system

Question 7

Calculate the BSA using the Mostellar formula when provided.

Answer 7

• Square root of [weight (kg) x height (cm)/3600]
• Centimeters = height in inches x 2.54
• Ex: 100 mg/m2 for a 6’1” & 78 kg male
  Square root of [78 x 180.34/3600] = 2.00 m2
  100 mg/m2 x 2.00 m2 = 200 mg dose

Question 8

Explain how traditional chemotherapy is given to balance efficacy and safety.

Question 9

Compare the effects of different dosing strategies for both cell-cycle specific and cell-cycle nonspecific chemotherapy.

Question 10

Utilize knowledge of pharmaceutical sciences to predict drug effects in clinical scenarios.

Question 11

Describe how dose limiting toxicities help determine chemotherapy dosing.

Question 12

Calculate a chemotherapy dose when given patient parameters, chemo regimen doses (mg/m2), and BSA formulas.