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Fractionated carboplatin radiosensitization: a phase I dose-escalation study
M I Koukourakis1, I Stefanaki, A Giatromanolaki
1Department of Radiotherapy and Oncology, University Hospital of Iraklion, Crete, Greece.
American Journal of Clinical Oncology
|December 18, 1998
Summary
This study established a safe, high-dose carboplatin schedule for radiochemotherapy. The maximum tolerated dose allowed safe radiopotentiation during fractionated radiotherapy for lung and pelvis cancers.
Area of Science:
- Oncology
- Radiotherapy
- Pharmacology
Background:
- Carboplatin is a common drug in cancer radiochemotherapy.
- Optimal combination of carboplatin with fractionated radiotherapy remains undefined.
Purpose of the Study:
- To determine the maximum tolerated daily bolus dose of carboplatin for safe radiopotentiation.
- To evaluate a 10-day carboplatin schedule repeated twice during a 6-week radiotherapy course.
Main Methods:
- Dose escalation study in 72 patients with lung or pelvis malignancies.
- Carboplatin dose escalated from 38 mg/m² daily (10 days), with cohorts of 6 patients.
- Supportive care included granulocyte colony-stimulating factor, recombinant human erythropoietin, and amifostine.
Main Results:
- Doses up to 45 mg/m² were tolerated with no grade III-IV toxicity.
- Granulocyte colony-stimulating factor supported treatment at 52 mg/m².
- Amifostine mitigated toxicity at 59 mg/m², allowing completion of cycles in most patients.
- No increase in acute radiation toxicity observed.
Conclusions:
- A high-dose fractionated carboplatin schedule can be safely administered during radical radiotherapy.
- This regimen offers a potential advancement in cancer treatment protocols.
- Further research may refine supportive care strategies for optimal patient outcomes.