Determination of carboplatin dose by area under the curve in combination chemotherapy for senile non-small cell lung cancer

Abstract

To preliminarily determine the appropriate dosage of carboplatin (CBP) at AUC of 5 mg·Ml⁻¹·min⁻¹ in the combination chemotherapy for Chinese senile patients with non-small cell lung cancer (NSCLC). Thirty-five Chinese senile patients with NSCLC in advanced stage (III/IV) were given 96 cycles of combination chemotherapy. Chemotherapy schedules included Taxol+CBP, Gemzar+CBP and NVB+CBP. The dose of CBP was at 5 mg·mL⁻¹·min⁻¹ of area under the concentration-time curve (AUC). Side effects and quality of life were observed before and after the chemotherapy. Myelosuppression was severe and commonly observed. Grade 3/4 of granulocytopenia was found in 47.9% (46/96) of the patients and grade 3/4 of thrombocytopenia was noted in 28.1% (27/96) of the subjects. However, other side effects were slight. The mean score of quality of life (QOL), according to the criteria of QOL for Chinese cancer patients had reduced 6.8. At 5 mg·mL⁻¹·min⁻¹ by AUC, the hematological toxicity of CBP was severe and it had some negative effects on the QOL. The administration of CBP at 5 mg·mL⁻¹·min⁻¹ by AUC may be too high for Chinese senile patients with non-small cell lung cancer.

Keywords

senile patients / non-small cell lung cancer / carboplatin / area under the concentration-time curve / quality of life

References

[1] SunY.. SunY., ZhouJ. C.. Scoring of Quality of Life in Tumor Patients. Manual of Clinical Oncology (Chinese), 1996, Beijing, People’s Health Publishing House: 53

[2] Non Small Cell Lung Cancer Collaborative Group.. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomized clinical trials. Br Med J, 1995, 1(1): 899-909

[3] SweeneyC. J., ZhuJ., SandlerA. B., et al.. Outcome of patients with a performance status of 2 in Eastern Cooperative Oncology Group Study E1594. Cancer, 2001, 15: 2639-2647

[4] ZatloukalP., PetruzelkaL.. Gemcitabine/carbopltin in advanced non-small cell lung cancer. Lung Cancer, 2002, 38(Suppl2): S33-S36

[5] PaccagnellaA., FavarettoA., OnigaF., et al.. Cisplatin versus carboplatin in combination with mitomycin and inblastine in advanced non small cell lung cancer. A multicenter, randomized phase III trial. Lung Cancer, 2004, 43: 83-91

[6] SchillerJ. H., HarringtonD., BelaniC. P., et al.. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. New Engl J Med, 2002, 346: 92-98

[7] JelicS., MitrovicL., RadosavljevicD., et al.. Survival advantage for carboplatin substituting cisplatin in combination with vindesine and mitomycin C for stage IIIB and IV squamous-cell bronchogenic carcinoma: a randomized phase III study. Lung Cancer, 2001, 34: 1-13

[8] ChuQ., VincentM., LoganD., et al.. Taxanes as first-line therapy for advanced non-small cell lung cancer: a systematic review and practice guideline. Lung Cancer, 2005, 50(3): 355-374

[9] SculierJ. P., PaesmansM., ThiriauxJ., et al.. A comparison of methods of calculation for estimating carboplatin AUC with a retrospective pharmacokinetic-pharmacodynamic analysis in patients with advanced non-small cell lung cancer. Eur J Cancer, 1999, 35: 1314-1319

[10] ChuD. T., LuoY., LiJ. L., et al.. The efficacy and toxicity of carboplatin in AUC dosing in treatment of small-cell lung cancer. Chinese J Clinical Oncology, 2001, 28(1): 28-30

[11] OkamotoH., NagatomoA., KunitohH., et al.. Prediction of carboplatin clearance calculated by patient characteristics or 24-hour creatinine clearance: a comparison of the performance of three formulae. Cancer Chemother Pharmacol, 1998, 42: 307-312

[12] MartinD. A., JamesO. A., AllenS. L., et al.. Clinical Oncology, 20012nd ed.Beijing, Science Press: 385