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Comparison of two methods for carboplatin dosing in children with retinoblastoma
Author(s) -
Allen Steven,
Wilson Matthew W.,
Watkins Amy,
Billups Catherine,
Qaddoumi Ibrahim,
Haik Barrett H.,
RodriguezGalindo Carlos
Publication year - 2010
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22467
Subject(s) - carboplatin , medicine , dosing , confidence interval , renal function , retinoblastoma , urology , chemotherapy , cisplatin , biochemistry , chemistry , gene
Background 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. Patients and Methods We compared carboplatin doses between two groups of children with retinoblastoma that were treated using a flat dose of 560 mg/m 2 or a targeted AUC of 6.5 using a modified Calvert formula. Results Ninety‐eight patients with retinoblastoma received a total of 576 cycles of carboplatin (median 8 cycles). Fifty patients (51%) received a fixed dose per m 2 , 32 (33%) received a dose based on AUC, 1 patient received fixed dose per kilogram, and in 15 patients a combination AUC and fixed doses was used. The median cumulative carboplatin dose (mg/m 2 ) for patients who received eight cycles using fixed per m 2 dosing was 2151.8 (range, 1414.2–2852.0), compared to 1104.1 for nine patients who received eight 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 m 2 dose was 70% (range, 48–134%). Younger patients had larger differences. Patients receiving carboplatin based on fixed per m 2 dosing were 3.0 times more likely to have a platelet transfusion (95% confidence interval, 1.3–7.3). Conclusions 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. Pediatr Blood Cancer 2010;55:47–54. © 2010 Wiley‐Liss, Inc.