Best Antiemetic / Hydration Strategy During Cisplatin Chemoradiation (CRT)

  • Answer concept: 
    • Neurokinin-1 (NK1) receptor antagonist and a 5-Hydroxytryptamine-3 (5-HT3) receptor antagonist + Dexamethasone with aggressive IV hydration and Mg / K supplementation
  • Why: 
    • Cisplatin is highly emetogenic:
      • Triple prophylaxis is standard
    • Hydration / Mg reduce nephrotoxicity
  • Pitfalls: 
    • Under-treating weekly dose (still emetogenic)
    • Missing Mg monitoring
  • Refs: ASCO / ESMO CINV guidelines; supportive care standards

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