In the past few decades, new chemotherapeutic agents have been developed with greater antitumor activity than their predecessors but all the while limited by the broad ranges of toxicities. The development of newer and more specific chemotherapeutic agents continues to meet the same obstacles, namely, dose-limiting toxicities. The inability of these cytotoxic agents to distinguish between malignant and normal cells results in a lower dose-intensive therapy and, consequently, tumor control as well as impairment of patients' quality of life. Some of the toxicities that plague the alkylating and platinum-based agents now recognized as standard therapy in many gynecologic neoplasms include bone marrow suppression, nephrotoxicity, neurotoxicities, and electrolyte abnormalities (Table 1). Chemotherapy is not unique in this regard; radiotherapy in the treatment of endometrial, cervical, and vulvar cancer also produces a number of unpleasant side effects such as epithelial desquamation, mucositis, and anemia.