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Health care during administration of combined docetaxel-Mitomycin C-Vinblastin therapy in treatment of metastatic breast cancer patients

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Author(s): Mitrović Jasmina | Popović Branka | Jelečanin Dušanka

Journal: Archive of Oncology
ISSN 0354-7310

Volume: 11;
Issue: 3;
Start page: 226;
Date: 2003;
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Keywords: breast neoplasms | nursing care | antineoplastic combined chemotherapy protocols | drug toxicity

ABSTRACT
Background: New chemotherapy combinations are extensively investigated in metastatic breast cancer, especially in anthracycline resistant patients. However, the higher the treatment efficacy, usually the greater therapy side effects are reported. We present our health care experience in treating advanced breast cancer patients with three-drug combinations consisting of Taxotere, Mitomycin C and Vinblastin. Aim of the work was to evaluate the toxicity profile and the effectiveness of health care measures in prevention of chemotherapy side effects. Nurses interventions in prevention of complications due to therapy related toxicity were as follows: Regular check-ups of patients, monitoring for signs and symptoms of infection in severely neutropenic patients, monitoring for hemorrhagic syndrome in patients with severe thrombocytopenia, monitoring for the signs and symptoms of stomatitis and aseptic care of oral cavity in order to prevent oral mucosal damage. Methodology: From December 1998 to April 2000, 27 patients were included into the phase II study of metastatic breast cancer patients. The following therapy regime was used: Taxotere 80 mg/m 2 every 3 weeks Vinblastin 6mg/m 2 every 3 weeks, and Mitomycin C 12 mg/m 2 in 6-week intervals. Presented data are obtained from interviews, analysis of health care lists and patients' diaries, which they filled in at home. Results During the study, a total of 133 chemotherapy cycles were applied. Neutropenia of grade 3-4 was registered in 25/27 patients (93%), and only 12 patients (48%) had at least one episode of febrile neutropenia, which was manageable. Other toxicities were as follows: Thrombocytopenia of grade 3 in 1 out of 27 patients, without development of hemorrhagic syndrome, anemia of grade 3 in 3 women, neurosensory toxicity in 4 patients, and liquid retention in 6 patients. However, mucositis of grade 4 occurred in 1 patients, and grade 3 in 2 of them despite the rigorous health care interventions. Fatigue of grade 2 developed in 7 patients. Other toxicities were mild or moderate, the most frequent of which was diarrhea in 3 women. Conclusion: Our results confirm that a TXTR-MTC-VLB combination has considerable acute and cumulative side effects that are expected. However regular monitoring and in time nursing interventions may spare patients from suffering the severe complications due to chemotherapy side effects.
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