December 2007 treatment
 

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HIGH DOSE IFOSFAMIDE

What was different from previous treatments?

Lower dose for longer time: 3.2GM instead of 5GM ifosfamide and Mesna for 9 consecutive days instead of 7 days

Nausea treatment changed: Emend taken orally for 6 days. Use of palonosetron in the IV.

Conclusion: no nausea this time but I had tachicardia (fast heart beat) and it is not clear yet why.

Treatment details

day#1

IV#1:  5% dextrose, water 1050ml, potassium acetate 40meq rate 300ml/hr infuse 1070ml over 4H 2units dispensed

IV#2: sodium bicarbonate 500ml rate 250ml/hr infuse 500ML over 2Hr

IV#3: Sodium chloride 0,9% 55ml + palonosetron 0,25MG=5ML+ Dexamethasone 20MG =2 ML infuse 62ML over 0,33Hr

IV#4: Sodium chloride 0,9% 1050ml + ifosfamide 3.2GM=32ML + Mesna 3.2GM=32ML infuse 1114ml over 4 Hrs 279mL/HR

overnight IV: Sodium chloride 0,9% 36mL + ifosfamide 3,2GM=32ML + Mesna 3,2GM=32ML Rate=5.6ML/hr x 18 Hrs

day#2

IV#1: Dextrose 5%- Water 1050ML Potassium Acetate 40 MEQ= 20 ML infuse 1070mL over 4 Hrs 250mL/Hr

IV#2: Dextrose 5%- Water 55ML + Dexamethasone 20MG=2ML infuse 57ML over 0,33Hr

IV#3: sodium chloride 0,9% 55ML + Granisetron 2000MCG = 2ML infse 57mL over 0.33 Hours

IV#4: sodium bicarbonate 500ml rate 250ml/hr infuse 500ML over 2Hr 250mL/Hr

Overnight IV: Sodium chloride 0,9% 36mL + ifosfamide 3,2GM=32ML + Mesna 3,2GM=32ML Rate= 5ML/Hour x 20 Hours infuse 100ML over 20 Hrs

day#3 and 4

IV#1: Dextrose 5%- Water 1050ML Potassium Acetate 40 MEQ= 20 ML infuse 1070mL over 4 Hrs 250mL/Hr

IV#2: sodium bicarbonate 500ml rate 250ml/hr infuse 500ML over 2Hr 250mL/Hr

Overnight IV: Sodium chloride 0,9% 36mL + ifosfamide 3,2GM=32ML + Mesna 3,2GM=32ML Rate= 5ML/Hour x 20 Hours infuse 100ML over 20 Hrs

day#5

IV#1: sodium bicarbonate 500ml rate 250ml/hr infuse 500ML over 2Hr 250mL/Hr

IV#2: Dextrose 5%- Water 1050ML Potassium Acetate 40 MEQ= 20 ML infuse 1070mL over 4 Hrs 250mL/Hr

IV#3: Sodium chloride 0,9% 55ml + palonosetron 0,25MG=5ML infuse 60ML over 0,33hours

Overnight IV: Sodium chloride 0,9% 36mL + ifosfamide 3,2GM=32ML + Mesna 3,2GM=32ML Rate=5ML/Hour x 20 Hours  infuse 100ML over 20 Hrs

day#6, 7 and 8

IV#1: Dextrose 5%- Water 1050ML Potassium Acetate 40 MEQ= 20 ML infuse 1070mL over 4 Hrs 250mL/Hr

IV#2: sodium bicarbonate 500ml rate 250ml/hr infuse 500ML over 2Hr 250mL/Hr

IV#3: sodium chloride 0,9% 55ML + Granisetron 2000MCG = 2ML infse 57mL over 0.33 Hours

Overnight IV: Sodium chloride 0,9% 36mL + ifosfamide 3,2GM=32ML + Mesna 3,2GM=32ML Rate=5ML/Hour x 20 Hours  infuse 100ML over 20 Hrs

day#9

IV#1: sodium bicarbonate 500ml rate 250ml/hr infuse 500ML over 2Hr 250mL/Hr

IV#2: Dextrose 5%- Water 1050ML Potassium Acetate 40 MEQ= 20 ML infuse 1070mL over 4 Hrs 250mL/Hr mase it 125ml/hr

IV#3: sodium chloride 0,9% 1050ml + Mesna 3.2GM=32ML infuse 1083ml over 4 Hrs 271mL/HR

SCANS BEFORE AND AFTER CHEMO

According to the oncologist, we may not have waited long enough to do the last scan and that's why there isn't a lot of difference between the scan before and after the chemo. Nevertheless, I am showing below the cuts with the contrasts that show the most differences. My doctor thinks that the scan "after" shows necrosis in the middle of the tumor (with the darker contrast, you can see like a hole in the middle of the tumor. Note that the position of the tumor is circled in the page called "metastases")

Click on the image to enlarge it...

 

 

 

 

 

 

 

2nd High dose Ifosfamide cycle

This time, the dose is 3.3GM instead of 3.2GM.

The CT scan done at the end of the cycle shows no change compare to previous scan. It is decided to stop chemo and give radiation a try.

High Dose Ifosfamide

Scans before and after chemo

2nd high dose ifosfamide