Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study
| Autor: | Vanessa Potter, Catherine D'Souza, Carina Bristow, Amy Proffitt, Asmah Hussain, Andrew Wilcock, Vincent Crosby, Vickie E. Baracos, Richard O'Connor, I. Hennig |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine Oncology medicine.medical_specialty Lung Neoplasms 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Platinum chemotherapy Humans Medicine Dosing Lung cancer Aged Platinum business.industry Middle Aged medicine.disease Surgery Future study 030104 developmental biology 030220 oncology & carcinogenesis Body Composition Lean body mass Feasibility Studies Female business |
| Zdroj: | Supportive Care in Cancer. 25:1257-1261 |
| ISSN: | 1433-7339 0941-4355 |
| DOI: | 10.1007/s00520-016-3518-2 |
| Popis: | Current methods of dosing platinum-based chemotherapy are suboptimal. Potentially, taking lean body mass into account may help. To inform the design of a future study, we first examined the feasibility and acceptability of such an approach using dual-energy X-ray absorptiometry (DEXA) and explored aspects suggestive of over- and under-dosing.Patients with lung cancer offered platinum-based chemotherapy over 1 year were identified and, if eligible, invited to take part in a prospective feasibility study. Questionnaires examined acceptability of the DEXA scan and of a future study that randomized between traditional dosing and one adjusted according to body composition. Dose-limiting toxicity (DLT) and a lack of neutropenia explored potential over- and under-dosing, respectively.Of the 173 patients offered chemotherapy, 123 (71%) were ineligible, mostly because of failing entry criteria (84, 49%). Of the 50 approached, 18 (36%) participated, most receiving carboplatin, with 17 providing data. All found a DEXA scan acceptable; other assessments were fully completed, except nadir and pre-chemotherapy blood counts. Most (94%) were prepared to take part in a future study, although the additional hospital visits for a nadir blood count were unpopular with some. Five (29%) patients experienced six episodes of DLT which resulted in discontinuation (3), dose reduction (2) or change to a less toxic regimen (1). Nine (60%) patients experienced either no (2) or inconsistent (7) neutropenia.A randomized trial appears acceptable and feasible in patients receiving carboplatin. Adjustment of our entry criteria and avoiding a hospital visit for a nadir blood count should aid recruitment. |
| Databáze: | OpenAIRE |
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