Common adverse reactions of irinotecan in the treatment of small cell lung cancer

 Because of its high degree of sensitivity to chemotherapy, chemotherapy is the most important and basic treatment for patients with SCLC. The EP regimen has become the standard first-line treatment for limited stage and extensive stage of SCLC, with efficiency of 60% to 80%. However, due to the fast doubling time, high proliferation and acquired resistance, most patients have recurrence or metastasis in a few months. And IT demonstrates the first line treatment failure. They need further treatment of second-tier program.

So far, the recurrence of SCLC second-line chemotherapy of evidence based medicine is still very limited. Six months after the end of the first-line treatment recurrence recommended drugs topotecan, CPT-11, paclitaxel, docetaxel, gemcitabine, and to give priority to participate in clinical trials. In recent years, using irinotecan combined with cisplatin treatment of small cell lung cancer achieved a good effect, but because of the unique mechanism of action of irinotecan, there are some special adverse reactions. Strengthen the medication guide and health education to reduce the psychological stress and anxiety of patients due to adverse reactions due to chemotherapy for small cell lung cancer patients. Meticulous meticulously care, prevention and mitigation of chemotherapy adverse effects to ensure the smooth progress of chemotherapy. The pharmaceutical raw materials suppliers achieve satisfactory results.

Chemotherapy drugs can cause bone marrow function is suppressed, mainly for peripheral white blood cells, thrombocytopenia, especially granulocytes decreased. Strictly controlled chemotherapy indications, before chemotherapy, check the blood, bone marrow situation. The treatment given to the necessary nutritional support. After chemotherapy should be every other day routine, daily check when necessary. White blood cells, especially granulocytes decreased, the probability of infection will increase. Grade b, c neutropenia patients, patients should be allowed to line of protective isolation in a separate ward, the operation is strictly aseptic, bedside eliminate hand sanitizer, and to give a subcutaneous injection of recombinant human granulocyte colony-stimulating factor. Reduce visits, close monitoring of body temperature, if necessary, prophylactic antibiotic treatment to do blood cultures.

Chemotherapy drugs can cause nausea, vomiting, diarrhea and other gastrointestinal symptoms. Should be kept ward fresh air ventilation to reduce the accompanying visits. Chemotherapy routinely given 5 HT 3 receptor antagonists (such as hydrochloric acid tropisetron Joan, granisetron Joan), nausea, vomiting, severe cases, intravenous rehydration. The acetylcholine syndrome mainly medication at that time or hours 24 hours after diarrhea, abdominal pain, sweating, salivation, tearing, blurred vision and other. In first use, irinotecan users have acute acetylcholine syndrome, before the next use of the prophylactic use of atropine. Closely observed after the infusion of irinotecan diarrhea, abdominal pain, sweating, salivation, tearing, blurred vision and other symptoms, if any of these symptoms should contact their doctor to give treatment.

During the time in treatment of small cell lung cancer with irinotecan combined with cisplatin, close observation of patients and their adverse reactions are necessary. People should enhancing the patient's psychological care and strengthen the medication guidance or health education. The workers need to explain the drug's adverse reactions and make patients understand their disease and strengthen their confidence in order to reduce fear and anxiety of patients on chemotherapy. Clinical validation shows that detailed elaborate care has significantly effects on adverse effect‘s prevention and mitigation. They ensure the smooth progress of chemotherapy and achieve satisfactory results. Source:http://www.cospcn.com