Carboplatin-based combination chemotherapy for testicular cancer: relationship among administration dose of carboplatin, renal function and myelosuppression

Abstract

6例の精巣腫瘍患者に対し計22コースのカルボプラチンを基本とした多剤併用療法を施行した.AUC(曲線下面積)は, カルバートにより示された以下の公式により算出した.カルボプラチン投与量=AUC×(GFR+25), GFR; 糸球体濾過率.骨髄抑制の程度をいくつかのカテゴリーにより検討した.化学療法のコースを体表面積当たり投与量により2群に分けた.白血球及び血小板の減少率, 最低値はこの2群の間で有意差を認めなかった.AUCにより3群に分けた場合, AUCの高い群は骨髄抑制の程度が高かった

Carboplatin (CBDCA), a derivative of cis-diamminedichloroplatinum, has low renal and neural toxicity. The dose-limiting factor of this agent is myelosuppression. We experienced various degrees of myelosuppression, when the dose of CBDCA was determined by the body surface area (BSA) in CBDCA-based combination chemotherapy for testicular cancer. Calvert demonstrated that the dose of CBDCA administered should be adjusted by renal function, because CBDCA was excreted through the glomerulus. We report the relationship among 3 factors; the administration dose of CBDCA, renal function and the degree of myelosuppression. We treated 6 patients with testicular cancer. A total of 22 courses of CBDCA-based combination chemotherapy was performed. The area under the curve (AUC) was calculated by the following formula, which was demonstrated in Calvert's study. CBDCA dose = AUC x (GFR + 25), GFR; glomerular filtration rate. The degree of myelosuppression was examined. All chemotherapy courses were divided into 2 and 3 groups according to BSA and AUC, respectively. WBC and Plt reduction rates and nadir counts were significantly correlated with AUC, and showed no significant relationship to the dose determined by BSA. This study revealed that the degree of myelosuppression was closely related with AUC, which reflects the renal function.