Doz F
Institut Curie, département d'oncologie pédiatrique, Paris.
Bull Cancer. 2000 Aug;87 Spec No:25-9.
The use of carboplatin has become frequent in children solid tumours because of lower renal and otologic risks as compared to cisplatin. The efficacy of carboplatin has mainly been demonstrated when used in combination with other cytotoxic drugs: few phase II studies of carboplatin alone have been published in children. Because of its limiting haematologic toxicity, carboplatin has become the main platinum compound when used at high dose with hematopoietic stem cell rescue. Formula have been developed specifically in children to allow a determination of the prescribed dose using a targeted "area under the curve" rather than dose in mg/m2, which allows a better individual therapeutic adaptation. Long term follow-up after carboplatin treatment in childhood is mandatory mainly because of the mutagenic and hypofecondity potential risks.
由于与顺铂相比,卡铂的肾毒性和耳毒性风险较低,其在儿童实体瘤中的应用日益频繁。卡铂的疗效主要在与其他细胞毒性药物联合使用时得到证实:儿童单独使用卡铂的II期研究很少发表。由于其血液学毒性有限,卡铂在高剂量与造血干细胞救援联合使用时已成为主要的铂类化合物。已经专门为儿童开发了计算公式,以便使用靶向“曲线下面积”而非mg/m2剂量来确定规定剂量,从而实现更好的个体化治疗调整。儿童期卡铂治疗后的长期随访是必要的,主要是因为存在潜在的诱变和生育力低下风险。