Chemotherapy Treatment Visit Note

Chemotherapy Treatment Visit Note Cycle Details: Cycle 3 of FOLFIRI + Bevacizumab regimen. Drugs administered: Irinotecan (180 mg/m²), Leucovorin (400 mg/m²), 5-Fluorouracil (400 mg/m² bolus, 2400 mg/m² infusion over 46 hours), Bevacizumab (5 mg/kg). Premedications: Ondansetron 8mg IV, Dexamethasone 8mg IV, Famotidine 20mg IV. Infusion details: All drugs administered via central venous catheter with good venous return. No immediate infusion reactions observed. Toxicity Review: Nausea: Mild, controlled with prescribed antiemetics (ondansetron PRN). Fatigue: Moderate, improved from last cycle, patient able to perform most daily activities with rest periods. Neuropathy: Grade 1 sensory neuropathy (tingling in fingertips), no functional impairment. Blood counts: Neutrophil count 2.1 x 10^9/L, Platelet count 180 x 10^9/L, Haemoglobin 11.2 g/dL. All within acceptable range for treatment continuation. Performance status: ECOG 1. Examination: General: Alert and oriented, appears comfortable. Cardiovascular: S1S2, no murmurs, rubs, or gallops. Regular rhythm. Peripheral pulses 2+ and symmetrical. Respiratory: Lungs clear to auscultation bilaterally, no wheezes or crackles. Abdominal: Soft, non-tender, no hepatosplenomegaly. No ascites. Neurological: Cranial nerves intact, no focal deficits. Mild distal sensory deficit noted in upper extremities. Investigations: Laboratory results (dated 30 October 2024): Full Blood Count: WCC 4.5 x 10^9/L, Neutrophils 2.1 x 10^9/L, Hb 11.2 g/dL, Platelets 180 x 10^9/L. Liver Function Tests: ALT 30 U/L, AST 25 U/L, ALP 80 U/L, Bilirubin 0.6 mg/dL. All within normal limits. Renal Function Tests: Creatinine 0.8 mg/dL, eGFR >90 mL/min/1.73m^2. Normal. CT Abdomen/Pelvis (dated 25 October 2024): Stable disease with no new lesions and slight reduction in primary tumour size. No new evidence of metastatic disease. Plan: Ongoing chemo schedule: Continue FOLFIRI + Bevacizumab regimen as planned. Dose modifications: No dose modifications required for this cycle. Supportive care measures: Continue antiemetics as prescribed. Advised patient to continue hydrating well. Reviewed dietary recommendations for fatigue management. Discussed management strategies for peripheral neuropathy. Next appointment: Next chemotherapy cycle scheduled for 15 November 2024. Follow-up consultation with Dr. Thomas Kelly on 13 November 2024 to review progress.