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Chapter 10. Oncology Overview and Supportive Care

Which of the following is the correct route of administration for vincristine administration.

a. Intramuscular

b. Intrathecal

c. Intravenous (IV)

d. Oral

Answer c is correct. Vincristine may be administered intravenously by short (10-15 minute) infusion, slow IV push (1-2 minutes), or 24-hour continuous infusion.

Answer a is incorrect. Vincristine is a vesicant and should not be administered intramuscularly as it can cause severe tissue damage.

Answer b is incorrect. Vincristine and the other vinca alkaloids are fatal if administered intrathecally.

Answer d is incorrect. Vincristine is not orally bioavailable and must be administered intravenously.

Select the supportive care medication that is associated with fluid retention.

a. Erythropoietin

b. Filgrastim

c. Aprepitant

d. Oprelvekin

Answer d is correct. Oprelvekin may cause fluid retention; therefore, use caution in heart failure and hypertension patients. Other significant cardiovascular events associated with oprelvekin include arrhythmia, pulmonary edema, and cardiac arrest.

Answers a is incorrect. Darbepoetin is not associated with causing fluid retention. It has been associated with worsening outcomes in patients with cancer and should only be used in patients who have cancer that is considered to be incurable.

Answer b is incorrect. Peg-filgrastim is not associated with causing fluid retention. The most common side effect attributed to colony stimulating factor (CSFs), such as peg-filgrastim, is bone pain.

Answer c is incorrect. Amifostine is not associated with causing fluid retention. The most notable side effects from amifostine are hypotension and nausea/vomiting.

WF is a 70-year-old man with a recent diagnosis of Stage IV colorectal cancer with the primary tumor in the sigmoid colon and multiple metastases found in his liver. The oncologist indicated that cure is not a realistic goal of treatment for WF because of his advanced disease. He is scheduled to begin chemotherapy with the regimen FOLFOXIRI, which contains 5-fluorouracil, leucovorin, oxaliplatin, and irinotecan. In addition, the patient is to receive bevacizumab. What is the term for chemotherapy that is being used with the intention of prolonging life and improving quality of life but not of curing the patient?

a. Curative intent

b. Stabilization intent

c. Palliative intent

d. Hospice intent


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