Comparison of two methods for carboplatin dosing in children with retinoblastoma.
Comparison of two methods for carboplatin dosing in children with retinoblastoma.
复制标题
DOI：
10.1002/pbc.22467
复制
发表时间：
2010-07-15
影响因子：
3.2
通讯作者：
Rodriguez-Galindo, Carlos
中科院分区：
文献类型：
--
作者：
Allen, Steven;Wilson, Matthew W.;Watkins, Amy;Billups, Catherine;Qaddoumi, Ibrahim;Haik, Barrett H.;Rodriguez-Galindo, Carlos
卡铂是治疗视网膜母细胞瘤最有效的药物，但在年轻患者中全身清除率是可变的。虽然大多数治疗方案使用固定剂量，但个体化靶向可能会提供更多调整的全身暴露。我们比较了两组视网膜母细胞瘤儿童的卡铂剂量，这两组儿童使用560 mg/m2的固定剂量或使用改良的Calvert公式的目标AUC 6.5进行治疗。98例视网膜母细胞瘤患者共接受了576个周期的卡铂治疗（中位8个周期）。50例患者（51%）接受固定剂量/m2，32例（33%）接受基于AUC的剂量，1例患者接受固定剂量/kg，15例患者使用AUC和固定剂量的组合。接受8个周期使用固定每m2剂量的患者的中位累积卡铂剂量（mg/m2）为2151.8（范围，1414.2 - 2852.0），而接受8个周期使用Calvert剂量的9例患者为1104.1（范围，779.0 - 1992.7）（p<0.001）。对于使用AUC给药的周期，假设固定/m2剂量的中位百分比为70%（范围：48%-134%）。年轻患者差异较大。接受卡铂固定剂量/m2给药的患者进行血小板输注的可能性高3.0倍（95%置信区间，1.3-7.3）。卡铂给药需要考虑在生命的最初几个月内发生的肾功能变化。使用靶向AUC提供了最准确的方法;然而，mg/kg体重给药是一种非常可靠的替代方法。
Carboplatin is the most effective drug in retinoblastoma but systemic clearance is variable in young patients. While most regimens use a flat dose, individualized targeting may provide a more adjusted systemic exposure. We compared carboplatin doses between two groups of children with retinoblastoma that were treated using a flat dose of 560 mg/m2 or a targeted AUC of 6.5 using a modified Calvert formula. Ninety-eight patients with retinoblastoma received a total of 576 cycles of carboplatin (median 8 cycles). Fifty patients (51%) received a fixed dose per m2, 32 (33%) received a dose based on AUC, one patient received fixed dose per kilogram, and in 15 patients a combination AUC and fixed doses was used. The median cumulative carboplatin dose (mg/m2) for patients who received 8 cycles using fixed per m2 dosing was 2151.8 (range, 1414.2 – 2852.0), compared to 1104.1 for 9 patients who received 8 cycles using Calvert dosing (range, 779.0 – 1992.7)(p<0.001). For cycles given using AUC, the median percentage of the hypothetical fixed per m2 dose was 70% (range, 48%–134%). Younger patients had larger differences. Patients receiving carboplatin based on fixed per m2 dosing were 3.0 times more likely to have a platelet transfusion (95% confidence interval, 1.3–7.3). Carboplatin administration needs to consider the changes in renal function occurring during the first months of life. The use of a targeted AUC provides the most accurate method; however, mg per kg of body weight dosing is a very reliable alternative method.
登录
查看更多内容
影响因子：
3
作者：
ARANT, BS
通讯作者：
ARANT, BS
影响因子：
3
作者：
Donahue, A;McCune, JS;Lindley, C
通讯作者：
Lindley, C
影响因子：
8.4
作者：
Dooley, MJ;Poole, SG;Webster, LK
通讯作者：
Webster, LK
影响因子：
6.7
作者：
MADDEN, T;SUNDERLAND, M;RODMAN, JH
通讯作者：
RODMAN, JH
影响因子：
45.3
作者：
Beck, MN;Balmer, A;Munier, F
通讯作者：
Munier, F