"Her Oncologist ordered specifically for her to receive Cisplatin 1st as opposed to their usual routine of Gemzar then Cisplatin. This was also clarified by the nurse. Apparently, there has been a study/clinical trial done sometime in 2011 regarding this matter."
In my opinion,the only regimen(Taxol/Cisplatin or oxaliplatin and carboplatin) that may use for liver or CCA is the only chemotherapy regimen that required a specific order of adminstration. that is Taxol first and cisplatin later for the maximum benefit.if you want ,you can go the the experience forum look under the chemo forum title:Hey percy,could you----" and you will have a general knowledge about each chemo agent;also look under title"systemic chemotherapy" for the combination regimens; for controlling nausea/vomiting ,go to the adverse reaction and side effects forum look under:"suggestion for medication for nausea and vomiting "
I look up the oncology nursing handbook as well as a couple regimen protocols from univ. of Pitt and another univ. out patient chemotherapy clinic; and the hospital I had my chemotherapy before; All are giving the pre-med zofran first,then give the gemcitabine over 30 min;Iv 0.9% sodium cholide for hydration and then give you the cisplatin over 2 hours.;
sometimes longer. Inside the cisplatin bag;they also add the manitrol (a diuretic)to facilitate the kidney function to deal with the toxic effect that will caused by the cisplatin.And after you finish the whole infusion;they will ask a you to drink more fluids (4-6glass of 8oz) to help flush out the cisplatin and protect your kidney better.
When gemcitabine and cisplatin giving together they will have the so call "synergistic effects" for the combination of the two chemotherapy agents.
As you know I am not a doctor; I am only a patient,but I do not think the order of administration in CCA to give cisplatin first is that much a deal; I ,myself only will not change it since the order of administration that use now already provide the "synergistic effect" benefit and use for quite a long time.
However,the following link is very interesting and give you another opinion that support the current order of administration of gemcitabine first,then cisplatin.
I love to know where your doctor got the idea; if you can find out the article for me,I appreciate.
Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.