Suzuki K, Matsumoto K, Hashimoto K, Kurokawa K, Jinbo S, Suzuki T, Imai K, Yamanaka H, Kawashima K, Takahashi H
Department of Urology, Gunma University School of Medicine.
Hinyokika Kiyo. 1995 Oct;41(10):775-80.
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.
卡铂（CBDCA）是顺二氨二氯铂的衍生物，具有较低的肾毒性和神经毒性。该药物的剂量限制因素是骨髓抑制。在以卡铂为基础的睾丸癌联合化疗中，当根据体表面积（BSA）确定卡铂剂量时，我们经历了不同程度的骨髓抑制。卡尔弗特证明，由于卡铂通过肾小球排泄，因此应根据肾功能调整卡铂的给药剂量。我们报告了三个因素之间的关系：卡铂的给药剂量、肾功能和骨髓抑制程度。我们治疗了6例睾丸癌患者。共进行了22个疗程的以卡铂为基础的联合化疗。曲线下面积（AUC）通过以下公式计算，该公式在卡尔弗特的研究中得到了证实。卡铂剂量 = AUC ×（肾小球滤过率 + 25），肾小球滤过率；肾小球滤过率。检查骨髓抑制程度。所有化疗疗程分别根据体表面积和曲线下面积分为2组和3组。白细胞和血小板减少率及最低点计数与曲线下面积显著相关，与根据体表面积确定的剂量无显著关系。本研究表明，骨髓抑制程度与反映肾功能的曲线下面积密切相关。
