Active Ingredient: Hydroxycarbamide
The treatment of cancer of the cervix in conjunction with radiotherapy.
For this indication, competent medicine agencies globally authorize below treatments:
For:
Oral, 80 milligrams hydroxycarbamide per kilogram of body weight, once every 3 days.
Treatment regimens can be continuous or intermittent. The intermittent regimen, with its diminished effect on the bone marrow, is more satisfactory for the management of cancer of the cervix.
Hydroxycarbamide should be started 7 days before concurrent irradiation therapy. If hydroxycarbamide is used concomitantly with radiotherapy, adjustment of radiation dosage is not usually necessary.
An adequate trial period for determining the antineoplastic effect of hydroxycarbamide is six weeks. Where there is a significant clinical response therapy may be continued indefinitely, provided that the patient is kept under adequate observation and shows no unusual or severe reactions. Therapy should be interrupted if the white cell count drops below 2.5x109 L or the platelet count below 100x109/L.
In these cases, the counts should be reevaluated after three days and therapy resumed when the counts return to acceptable levels. Hematopoietic rebound is usually rapid. If rapid rebound has not occurred during combined hydroxycarbamide and irradiation therapy, irradiation may also be interrupted. Anaemia, even if severe, can be managed without interrupting hydroxycarbamide therapy.
Severe gastric distress, such as nausea, vomiting, and anorexia, resulting from combined therapy may usually be controlled by interruption of hydroxycarbamide administration.
Pain or discomfort from inflammation of the mucous membranes at the irradiated site (mucositis) is usually controlled by measures such as topical anaesthetics and orally administered analgesics. If the reaction is severe, hydroxycarbamide therapy may be temporarily interrupted; if it is extremely severe, irradiation dosage may, in addition, be temporarily postponed.
Intermittent therapy: hydroxycarbamide 80 mg/kg in single doses should be given every third day. Using the intermittent regimens, the likelihood of WBC depression is diminished, but if low counts are produced, 1 or more doses of hydroxycarbamide should be omitted.
Elderly patients may be more sensitive to the effects of hydroxycarbamide and may require a lower dosage regimen.
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