Protokol Kemoterapi CRC

BEDAH DIGESTIF PROTOKOL KEMOTERAPI CRC
Simplified (sLV5FU2)
(5FLUOROURACIL + LEUCOVORIN)
DOSIS 5Fluorouracil 400 + (1200+1200) mg/m2 Leucovorin 400 mg/m2
Nama : No CM : No Telp :
Umur : tahun L/P Alamat :
Diagnosis : (T .. N .. M .. )
Tindakan : (Tgl ... .)
Karnofsky : CEA : . TB : cm BSA : m2
ECOG : .. Ca 19.9 : BB : . kg
Efek samping / penyulit kemoterapi sebelumnya :
MSI : ...
CARA PEMBERIAN
Siklus 1 2 3 4 5 6 7 8 9 10 11 12
Tanggal
Infuse Dextrose 5% 100 ml

( 30 menit ) Premedikasi: - Dexametason 15 mg (iv)
- Ondansentron 16 mg (iv)
- Ranitidin 50 mg (iv)
Dextrose 5% 250 ml + Leucovorin ........... mg

( > 2 jam )
Dextrose 5% 100 ml
Hari I ( 15 menit)
Bolus : 5 FU ..................... mg
( 1-2 menit )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam ) habis
Hari II
NaCl 0,9% 100 ml
\ ( 15 menit)
- Diulang setiap 2 minggu

- Diberikan total selama 6 bulan atau 12 siklus
SMF Bedah Digestif
dr. Sjaiful Bachri, SpB-KBD

CapeOX
(CAPECITABINE + OXALIPLATIN)
DOSIS Capecitabine 850-1000 mg/m2 Oxaliplatin 130 mg/m2
ECOG : .. Ca 19.9 : BB : . kg
MSI : ...
SNPs : .................
CARA PEMBERIAN
Siklus 1 2 3 4 5 6 7 8
Tanggal
Capecitabin Pagi : ......................... tablet

(xeloda) Hari ke 1 - 14
Malam : ......................... tablet
Vitamin Neurotropik : 1 tablet
( 30 menit )
Premedikasi: - Dexametason 15 mg (iv)

Hari ke 1
SAJA
Dextrose 5% + Oxaliplatin .............. mg
( > 2 jam )
Dextrose 5% 100 ml
( 15 menit )
- Capecitabin (xeloda) tablet diminum dua kali sehari selama 14 hari, kemudian istirahat 7 hari
- Oxaliplatin diberikan per-infus pada hari pertama saja setiap siklus
- Diulang seperti diatas setiap 3 minggu
- Diberikan selama 6 bulan atau 8 siklus
SMF Bedah Digestif

BEDAH DIGESTIF PROTOKOL KEMOTERAPI mCRC
mFOLFOX6-Bev
(5FLUOROURACIL + LEUCOVORIN + OXALIPLATIN + BEVACIZUMAB)
DOSIS 5Fluorouracil 400 + (1200+1200) mg/m2 Leucovorin 400 mg/m2 Oxaliplatin 85 mg/m2 Bevacizumab 5 mg/kg
ECOG : .. Ca 19.9 : BB : . kg
Efek samping / penyulit kemoterapi sebelumnya : MSI : ...
.. SNPs : .................
.. KRAS : .................
.......................................................................................................................................... NRAS: .................
BRAF: .................
CARA PEMBERIAN
Siklus 1 2 3 4 5 6 7 8 9 10 11 12
Tanggal
Infuse NaCl 0,9% 100 ml

Premedikasi: - Dexametason 15 mg (iv)
( 30 menit )
NaCl 0,9% 100 ml + Bevacizumab ......... mg

( 60-90 menit )
Dextrose 5% 100 ml
( 15 menit)
Dextrose 5% 250 ml + Oxaliplatin ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg Hari I

( > 2 jam ) ( > 2 jam )
Dextrose 5% 100 ml
( 15 menit)
- Diberikan 6 bulan atau 12 siklus
Bolus : 5 FU ..................... mg
- Diberikan selama 2-3 bulan bila
( 1-2 menit )
sebagai kemoterapi neoadjuvan
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam ) habis
Hari II
SMF Bedah Digestif NaCl 0,9% 100 ml
( 15 menit)

mFOLFOX6
(5FLUOROURACIL + LEUCOVORIN + OXALIPLATIN)
DOSIS 5Fluorouracil 400 + (1200+1200) mg/m2 Leucovorin 400 mg/m2 Oxaliplatin 85 mg/m2
ECOG : .. Ca 19.9 : BB : . kg
MSI : ...
SNPs : .................
CARA PEMBERIAN
Siklus 1 2 3 4 5 6 7 8 9 10 11 12
Tanggal

( 30 menit ) Premedikasi: - Dexametason 15 mg (iv)
Dextrose 5% 250 ml + Oxaliplatin ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg

( > 2 jam ) ( > 2 jam )
Dextrose 5% 100 ml
Hari I ( 15 menit)
Bolus : 5 FU ..................... mg
( 1-2 menit )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam ) habis
Hari II NaCl 0,9% 100 ml

( 15 menit)
- Diberikan selama 2-3 bulan bila sebagai kemoterapi neoadjuvan
SMF Bedah Digestif

FOLFIRI
(5FLUOROURACIL + LEUCOVORIN + OXALIPLATIN)
DOSIS 5Fluorouracil 400 + (1200+1200) mg/m2 Leucovorin 400 mg/m2 Irinitecan 180 mg/m2
ECOG : .. Ca 19.9 : BB : . kg
MSI : ...
SNPs : .................
CARA PEMBERIAN
Siklus 1 2 3 4 5 6 7 8 9 10 11 12
Tanggal

( 30 menit ) Premedikasi: - Dexametason 15 mg (iv) - Difenhidramin 1 amp (iv)
- Ondansentron 16 mg (iv) - SA 0,25 1 amp (iv)
Dextrose 5% 250 ml + Irinotecan ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg

( 60-90 menit ) ( > 2 jam )
Dextrose 5% 100 ml
Hari I ( 15 menit)
Bolus : 5 FU ..................... mg
( 1-2 menit )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam ) habis
Hari II NaCl 0,9% 100 ml

( 15 menit)
- Diberikan selama 2-3 bulan bila sebagai kemoterapi neoadjuvan
SMF Bedah Digestif

FOLFIRI-Cet
(5FLUOROURACIL + LEUCOVORIN + IRINOTECAN+ CETUFXIMAB)
DOSIS 5Fluorouracil 400 + (1200+1200) mg/m2 Leucovorin 400 mg/m2 Irinotecan 180 mg/m2 Cetufximab 500 mg/m2
ECOG : .. Ca 19.9 : BB : . kg
.. SNPs : .................
.. KRAS : .................
.......................................................................................................................................... NRAS: .................
BRAF: .................
CARA PEMBERIAN
Siklus 1 2 3 4 5 6 7 8 9 10 11 12
Tanggal

Premedikasi: - Dexametason 15 mg (iv) - Difenhidramin 1 amp (iv)
( 30 menit ) - SA 0,25 1 amp (iv)
Cetufximab .................... mg
( > 2 jam )
Dextrose 5% 100 ml
( 15 menit)
Dextrose 5% 250 ml + Irinotecan ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg Hari I

( 60-90 menit ) ( > 2 jam )
Dextrose 5% 100 ml
( 15 menit)
- Diberikan 6 bulan atau 12 siklus Bolus : 5 FU ..................... mg
- Diberikan selama 2-3 bulan bila
( 1-2 menit )
sebagai kemoterapi neoadjuvan
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam ) habis
Hari II
SMF Bedah Digestif NaCl 0,9% 100 ml
( 15 menit)

FOLFIRI-Bev
(5FLUOROURACIL + LEUCOVORIN + IRINOTECAN+ BEVACIZUMAB)
DOSIS 5Fluorouracil 400 + 2400 mg/m2 Leucovorin 400 mg/m2 Irinotecan 180 mg/m2 Bevacizumab 5 mg/kg
ECOG : .. Ca 19.9 : BB : . kg
.. SNPs : .................
.. KRAS : .................
.......................................................................................................................................... NRAS: .................
BRAF: .................
CARA PEMBERIAN
Siklus 1 2 3 4 5 6 7 8 9 10 11 12
Tanggal

Premedikasi: - Dexametason 15 mg (iv) - Difenhidramin 1 amp (iv)
( 30 menit ) - SA 0,25 1 amp (iv)
Dextrose 5% 250 ml + Irinotecan .................... mg Dextrose 5% 250 ml + Leucovorin ......... mg

( 60-90 menit ) ( > 2 jam )
Dextrose 5% 100 ml
( 15 menit)
- Diberikan 6 bulan atau 12 siklus
- Diberikan selama 2-3 bulan bila Bolus : 5 FU ..................... mg Hari I
sebagai kemoterapi neoadjuvan ( 1-2 menit )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam )
NaCl 0,9% 1000 ml + 5 FU ........................ mg

( > 24 jam ) habis
NaCl 0,9% 100 ml + Bevacizumab ........................ mg

( 60-90 menit ) Hari II
NaCl 0,9% 100 ml

( 15 menit)
SMF Bedah Digestif

Protokol Kemoterapi CRC

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BEDAH DIGESTIF PROTOKOL KEMOTERAPI CRC

Infuse Dextrose 5% 100 ml

Dextrose 5% 250 ml + Leucovorin ........... mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

- Diulang setiap 2 minggu

SMF Bedah Digestif

dr. Sjaiful Bachri, SpB-KBD

Capecitabin Pagi : ......................... tablet

Premedikasi: - Dexametason 15 mg (iv)

SMF Bedah Digestif

dr. Sjaiful Bachri, SpB-KBD

Infuse NaCl 0,9% 100 ml

NaCl 0,9% 100 ml + Bevacizumab ......... mg

Dextrose 5% 250 ml + Oxaliplatin ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg Hari I

NaCl 0,9% 1000 ml + 5 FU ........................ mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

dr. Sjaiful Bachri, SpB-KBD

Infuse Dextrose 5% 100 ml

Dextrose 5% 250 ml + Oxaliplatin ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

Hari II NaCl 0,9% 100 ml

SMF Bedah Digestif

dr. Sjaiful Bachri, SpB-KBD

Infuse Dextrose 5% 100 ml

Dextrose 5% 250 ml + Irinotecan ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

Hari II NaCl 0,9% 100 ml

SMF Bedah Digestif

dr. Sjaiful Bachri, SpB-KBD

Infuse NaCl 0,9% 100 ml

Dextrose 5% 250 ml + Irinotecan ......... mg Dextrose 5% 250 ml + Leucovorin ......... mg Hari I

NaCl 0,9% 1000 ml + 5 FU ........................ mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

dr. Sjaiful Bachri, SpB-KBD

Infuse NaCl 0,9% 100 ml

Dextrose 5% 250 ml + Irinotecan .................... mg Dextrose 5% 250 ml + Leucovorin ......... mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

NaCl 0,9% 1000 ml + 5 FU ........................ mg

NaCl 0,9% 100 ml + Bevacizumab ........................ mg

NaCl 0,9% 100 ml

SMF Bedah Digestif

dr. Sjaiful Bachri, SpB-KBD

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