Nakamura T, Onishi Y, Kono T, Maeda T, Wada T, Hatae M
Dept. of Obstetrics and Gynecology, Kagoshima City Hospital.
Gan To Kagaku Ryoho. 1997 Mar;24(5):579-83.
Several studies have shown that carboplatin AUC seems to correlate with therapeutic outcome and hematologic toxicity. Calvert's formula predicts carboplatin AUC using GFR estimated by the 51Cr-EDTA method. It is very complicated to manage radioactive agents, so we use 24-hour creatinine clearance before carboplatin administration as GFR in Calvert's. Recently, Chatelut reported a formula to predict carboplatin AUC using serum creatinine as a variable parameter of renal function as well as age, sex and body weight. We measured the AUC of free Pt by serial sampling in 14 ovarian cancer patients who received carboplatin by one-hour infusion in the initial treatment course. We evaluated the two predictive formulas with measured AUC. Calvert's predicted AUC showed a linear correlation with actual AUC (r = 0.768, p = 0.0013). But using Chatelut's formula, the predicted AUC had a better correlation with actual AUC (r = 0.833, p = 0.0002). Actual AUC correlated inversely with nadir PLT counts (r = -0.707, p = 0.0047). In conclusion, Chatelut's prediction had a better correlation with the actual AUC of carboplatin and nadir of thrombocyte count than Calvert's. Chatelut's formula was thus more useful to predict the carboplatin AUC than Calvert's when 24-hour creatinine clearance was used as GFR.
多项研究表明,卡铂的曲线下面积(AUC)似乎与治疗效果和血液学毒性相关。卡尔弗特公式使用通过51Cr-EDTA方法估算的肾小球滤过率(GFR)来预测卡铂的AUC。管理放射性药物非常复杂,因此我们在卡尔弗特公式中使用卡铂给药前的24小时肌酐清除率作为GFR。最近,沙泰吕报道了一个使用血清肌酐作为肾功能可变参数以及年龄、性别和体重来预测卡铂AUC的公式。我们对14例在初始治疗疗程中接受1小时静脉滴注卡铂的卵巢癌患者进行连续采样,测量游离铂的AUC。我们用测量的AUC评估这两个预测公式。卡尔弗特公式预测的AUC与实际AUC呈线性相关(r = 0.768,p = 0.0013)。但使用沙泰吕公式时,预测的AUC与实际AUC的相关性更好(r = 0.833,p = 0.0002)。实际AUC与最低点血小板计数呈负相关(r = -0.707,p = 0.0047)。总之,与卡尔弗特公式相比,沙泰吕公式的预测与卡铂的实际AUC以及血小板计数最低点的相关性更好。因此,当使用24小时肌酐清除率作为GFR时,沙泰吕公式在预测卡铂AUC方面比卡尔弗特公式更有用。