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NSCLCADJ

Dec 05, 20232 min read

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🌱來自: snippets

NSCLCADJ

Nonsmoker/Exsmoker/smoker, Asian, Woman/man 00 y/o year

RUL lung CA s/p VATS RUL lobectomy + RLND with smoothly recovery on 2020/00/00, pT2aN0(0/22)M0, LVI+, M/D ADENOCARCINOMA, papillary predominant, grading 4

  • Initial presentation:
  • Follow up parameter: PE, CEA, and CXR Q3M for 3 years. CT Q6M for 2 years then yearly. Optional bone scan
  • 2020/00/00: Chest CT:
  • 2020/00/00: Brain MRI:
  • Treatment plan: adjuvant chemotherapy with vinorelbine + cisplatin or caboplatin but self-paid 4 cycles, optional UFT (400mg/day divided into 2 doses, post op 3 weeks later, for T1, T2 disease) for 2 year depends on patient’s preference.
  • 2020/00/00: Explain the purpose of adjuvant chemotherapy is decrease risk of local recurrence or distant metastasis but not 100% prevention. The risk of reduction is 20% (HR 0.8189) @ Adjuvant chemotherapy will be given 48 weeks post operation on (6th week) @ Vascular assessment, nutritional assessment, dental check, pharmacist education before chemotherapy. @ Check viral marker before treatment **explain the AEs of chemotherapy, such as myelosuppression, neutropenic fever, alopecia, , moderate nausea/vomiting, constipation(35%), diarrhea(17%), stomatitis(<20%), anorexia (<20%), neurotoxicity and alopecia (1015%) **explain the AEs of carboplatin, such as myelosuppression which is dose-limiting, especially in elder patients, thrombocytopenia is most commonly observed, nausea and vomiting, less renal toxicity as compared to cisplatin, peripheral neuropathy < 10% and less as compared to cisplatin, and hypersensitivity **explain the AEs of cisplatin, such as nephrotoxicity, dose limiting up to 3540%, electrlyte abnormalites (Mg, Ca, K), nausea/vomting, myelosuppresion, neurotoxicity, ototoxicity, and hypersensitivity

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