Many toxic effects can be minimized or avoided if treatment toxicity is carefully evaluated. Management of treatment toxicity also raises the cost of treatment and can reduce its cost-effectiveness. The latter is particularly important in pediatric patients because of the effects of treatment on growth and development. The frequency of each syndrome should also be determined, including the frequencies observed at different doses. In addition, the degree of cardiac dysfunction and the duration of each type of cardiotoxicity should be assessed.
Toxicities are subjective, objective, or both.
The evaluation of a subjective toxicity is begun by asking the patient whether the toxicity occurred. Just because the patient does not report toxic symptoms voluntarily does not mean that they did not occur. If the toxicity has occurred, patients should next be asked to describe the severity and duration of the toxicity. Subjective toxicities can be evaluated by patient interview or a reliable, valid patient-completed questionnaire. 22-26 Objective toxicities are measured by physical examination or laboratory tests.