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RECTALADJ

Dec 05, 20232 min read

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🌱來自: snippets

RECTALADJ

Rectal cancer, 6 cm from anal verge, S/P CCRT(?) s/p laparoscopic proctectomy and ileostomy on 2017/00/00 ypT2N0(0/16)

  • Initial presentation:
  • 2017/00/00 explained the concept of adjuvant chemotherapy, the goal is to decrease recurrence/metastasis as possible, not guarantee cure!! Thus regular follow up is still needed. CEA need F/U. Adjuvant chemotherapy will be started post op 4~6 weeks
  • for N+(1) status, there is HIGH risk of recurrence or metastasis, adjuvant chemotherapy is suggested, offered options included
  • for initial cT3N0 and ypT2N0 status, offered options included <1> mFOLFOX6, oxaliplatin is self-paid, bi-weekly for 12 cycles <2> Weekly 5FU/LV, (打3休1) for 8 cycles <3> XELODA[20002500mg/m2](4# BID),(self-paid) 14 days on/7 days off, for 8 cycles <4> UFT(UFT 300mg/m2 and LV 3090mg/m2, D1-D28, 1 wk rest) for 0.5 to 3 year @ Arrange admission for #1 mFOLFOX-6 on ? and check lab. @ Vascular assessment, nutritional assessment, dental check, pharmacist education before chemotherapy. 5FU: **GI upset(nausea/vomiting/diarrhea), elevations in LFT, myelosuppression, hyperammoninemia, and rare but possible ischemic heart disease Oxaliplatin: **peripheral sensory neuropathy, nausea/vomting, diarrhea, myelosuppression, anaphylaxis **Emphasize the importance of nutrional support (high protein diet) during C/T period.

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