Information
Cyclophosphamide + Doxorubicin + 5-Flourouracil (CAF-Oral)1,44- Prechemo: CBC, Chem, LFTs, and CA 27–29. MUGA scan. 5-HT3 and dexamethasone 20 mg on days 1 and 8. Oral 5-HT3 or phenothiazine PO daily days 2–7 and 9–14. Moderately to highly emetogenic.
- Cyclophosphamide 100 mg/m2/day: PO on days 1–14. (25- and 50-mg tablets.) Take with meals in morning or early afternoon to allow adequate excretion time.
- Doxorubicin 30 mg/m2: IV on days 1 and 8. Potent vesicant.
- 5-Flourouracil 500 mg/m2: IV on days 1 and 8.
- Side effects: Cyclophosphamide can cause rhinitis and irritation of nose and throat. Myelosuppression may be severe. G-CSF recommended. Nausea and vomiting, acute or delayed. Stomatitis and diarrhea can be severe and dose-limiting. Acutely, pericarditis-myocarditis syndrome may occur. With cumulative doses >550 mg/m2 doxorubicin, cardiomyopathy may occur. Cyclophosphamide may increase the risk of doxorubicin-induced cardiotoxicity. Dose reduce with liver dysfunction. Hemorrhagic cystitis, dysuria, and urinary frequency with cyclophosphamide. Red-orange discoloration of urine. SIADH. Hyperpigmentation, photosensitivity, nail changes, and radiation recall occur. Complete alopecia. Hand-foot syndrome can be dose-limiting. Photophobia, increased lacrimation, acute and chronic conjunctivitis, blepharitis, and blurred vision.
- Chair time: 1 hour on days 1 and 8. Repeat cycle every 28 days for six cycles.