Background The new guidelines from the American Society of Clinical Oncology (ASCO) recommend full weight-based cytotoxic chemotherapy doses to treat obese patients with cancer, particularly when the goal is cure. Carboplatin is one exception and the recommendation is that the glomerular filtration rate used in the Calvert formula to calculate the doses should not exceed 125 ml/min.
Purpose To determine the dosing patterns and haematological toxicities in women with adjuvant paclitaxel and carboplatin for gynaecological malignancy and the relation with body mass index (BMI).
Materials and methods Retrospective study of women treated with adjuvant paclitaxel and carboplatin for ovarian and endometrial cancers between 2010 and 2013. Records were reviewed for patient age, weight, height, diagnosis, dates of treatment, dosing modifications and toxicity. BMI was used to classify patients as underweight (17.5–19.9), normal weight (20–24.9), overweight (25–29), or obese (30+).
Results We identified 38 women, with a mean age of 58 (range: 38–77. SD: 10). 18% were classified as underweight, 34% as normal weight, 32% as overweight and 16% as obese.
First cycle reductions for their age and performance status were made with paclitaxel in 3 women and with carboplatin in one woman. 65.8% and 31.6% of patients received carboplatin at an AUC 5 and 6.
Most common severe toxicities (grades 3 or 4) were neutropenia and thrombocytopenia (14 and 3 patients). The incidence of neutropenia grade 3/4 in the group with BMI 30+ was 0% whereas in the others: Overweight, 33% (p = 0.31); Normal weight, 50% (p = 0.11); Underweight, 57% (p = 0.1).
Conclusions The dosing of paclitaxel-carboplatin was appropriate, following the ASCO recommendations including for overweight and obese patients. Having the limitation of the small sample size, we recorded less neutropenia in the obese group.
No conflict of interest.
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