45 YO F with T3N0 anal SCC. She developed severe mucositis, diarrhea, and skin rash after cycle 1 of chemorad (5FU-Mitomycin) and was hospitalized for that. We are suspecting DPD deficiency. What are other chemo options if she truly has DPD deficiency?
This is a tough situation. I would first check degree of deficiency as some cases allow for 50% DR of 5FU. Otherwise you might be stuck with having to do platinum and Taxol.
