Radiation patient management

American Society of Health-System Pharmacists. ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery. Am J Health-Syst Pharm 1999 56 729-764. 

Educate the patient on the chemotherapy or endocrine therapy regimen chosen for the patient, focusing on what adverse events to expect, when to expect them, and how to manage them if they do occur. Also include in the initial education an overall plan of care, including the duration of therapy, other treatment modalities that will follow (e.g., radiation therapy, surgery, endocrine therapy), and when the patient will receive them. 

Secondary or salvage therapies for patients who progress after their initial therapy depend on what was used for initial management.26 For patients diagnosed initially with localized prostate cancer, radiotherapy can be used in the case of failed radical prostatectomy. Alternatively, androgen ablation can be used in patients who progress after either radiation therapy or radical prostatectomy. 

Corticosteroids play a key role in the management of SVCS, particularly in cases of lymphoma, because these tumors inherently respond to corticosteroid therapy. They are also helpful in the setting of respiratory compromise. Corticosteroids benefit patients who are receiving radiation therapy by reducing local radiation-induced inflammation and increased intracranial pressure. Dexamethasone 4 mg intravenously or by mouth every 6 hours is a frequently used regimen. The dosage should be tapered on completion of radiation therapy or resolution of symptoms. 

The regimes combining Orzel and capecitabine with radiation therapy have become the focus of increasing interest in the management of patients various malignancies including rectal, anal, locally advanced head and neck, esophageal, and pancreatic cancers. 

Although radiation alone has been utilized historically in the treatment of medically inoperable esophageal cancers and continues to be used today in the palliative setting, the standard of care for the nonsurgical management of localized esophageal cancer remains concurrent chemoradiation. For those patients who are unable to tolerate surgery or... 

Patients with locally advanced colon cancer and suspected microscopic or gross residual disease after surgery pose a difficult management problem. Postoperative radiation therapy in addition to standard chemotherapy may have some utility in sterilizing residual disease. In retrospective studies, local radiation therapy with or without concurrent chemotherapy achieves local control in46-70% of patients with microscopic residual... 

Radiation therapy contributes to the cure of 23% of all cancer patients [alone (12%) or in combination with surgery (6%) or chemotherapy/immunotherapy (5%)]. Thus about half of the cancer patients who are cured benefit from radiation therapy at least for part of their treatment this proportion illustrates the important role of radiation therapy in cancer management. 

SC 91-1 Precautions in the Management of Patients Who Have Received Therapeutic Amounts of Radionuclides SC 91-2 Radiation Protection in Dentistry SC 92 Public Policy and Risk Communication SC 93 Radiation Measurement and Dosimetry... 

Note. From Exposure of the Pregnant Patient to Diagnostic Radiations—A Guide to Management (2nd ed.), by L. K. Wagner, R. G. Lester, and L R. Saldana, 1997, Milwaukee, Wl Medical Physics Publishing. Reprinted with permission. ... 

Wagner, L. K., Lester, R. G., Saldana, L. R. (1997). Exposure of the pregnant patient to diagnostic radiations—A guide to medical management (2nd ed.). Milwaukee, WI Medical Physics Publishing. 

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