AUC of Calvert's formula in targeted intra-arterial carboplatin chemoradiotherapy for cancer of the oral cavity

Abstract

We investigated whether intra-arterial administration of carboplatin using Calvert's formula is useful for avoiding thrombocytopenia in targeted chemoradiotherapy in patients with squamous cell cancer of the oral cavity and oropharynx. Carboplatin was infused intraarterially under digital subtraction angiography in 28 patients. In the first group of patients, the dose of carboplatin was calculated according to the body surface area (BS group). In the second group, the dose was calculated using Calvert's formula (AUC group). The value for AUC (area under concentration vs time curve; mg ml À1 min À1 ) in the formula was set at 4.5. All patients received concurrent radiotherapy (30 Gy) and were given oral tegafur-uracil (UFT s , 400 -600 mg day À1 ). The AUC group showed a significantly lower percentage platelet reduction than the BS group (49.0722.0 vs 65.1723.2%; P ¼ 0.045) and also tended to have a higher platelet nadir count (10.974.2 vs 8.475.8 Â 10 4 ; P ¼ 0.27) without reducing the antitumour effect. The value of 4.5 for target AUC is recommended clinically. However, AUC of Calvert's formula could not predict thrombocytopenia associated with intraarterial chemoradiotherapy due to the variability of the actual AUC.

Superselective Intra-arterial Infusion Chemotherapy with Nedaplatin for Oral Cancer: A Pharmacological Study of the Dose Clearance

“…Finally, it would presumably be difficult to predict the side effects (e.g., hematological toxicity and gastrointestinal disturbance) individually after administration with a dosage based solely on BSA. For CBDCA, the relationship between the AUC, anti-tumor activity, and side effects has been investigated thoroughly [30][31][32]. The AUC of CDGP should also be a useful index for the purpose of predicting not only anti-tumor activity, but also other adverse side effects.…”

Blood vessel density correlates with the effects of targeted intra-arterial carboplatin infusion with concurrent radiotherapy for squamous cell carcinomas of the oral cavity and oropharynx

“…based either on the patient's body surface area (350 mg m À2 ), or according to Calvert's formula (4.5 times the area under the curve, AUC) after renal function had been assessed (Calvert et al, 1989;Oya et al, 2004). It was administered within about 20 s. When multiple nutrient arteries were present, the dose of carboplatin for each artery was determined based on the percentage of tumour stained with indigo carmine after each vascular infusion.…”