Estudio observacional sobre los criterios de dosificación de carboplatino en pacientes obesosevaluación de la efectividad y la toxicidad en función del criterio utilizado

Zusammenfassung

Observational study on carboplatin dosing criteria in obese patients. Evaluation of effectiveness and toxicity according to the criteria used. Objectives: The main aims of the study were: 1) To describe the carboplatin dosing criteria in obese patients in routine clinical practice at the Hospital Clínico Universitario Virgen de la Arrixaca. 2) Evaluation of the toxicity according to the criterion used. 3) Evaluation of the effectiveness in the majority diagnoses according to the criterion used. Methodology: An observational, retrospective, descriptive study, including all obese patients (BMI>30 kg/m2) who started treatment with carboplatin between 1st January 2012 and 31st January 2015. Characterization variables from the patient, disease and treatment were collected. As a result variables were collected: the method of calculating the dose of carboplatin, dosage criteria, others approximations in the dosage of carboplatin, treatment delays, dose reductions, relative dose intensity, adverse reactions and severity (CTCAE v. 4.0) as well as global survival and progressive free survival in the majority of the diagnoses. Conclusions: 1) The use of Calvert's formula for an objective AUC and the use of Cockcroft Gault's formula for the estimation of the glomerular filtration rate has been the method of dosing carboplatin in routine clinical practice at the Hospital Clínico Universitario Virgen de la Arrixaca. 2) The weight descriptors used in the Cockcroft Gault's formula were the actual body weight and the ideal adjusted body weight in similar proportions. 3) Dosing strategies using maximum doses or fixed doses have been used in fewer cases. 4) Greater use of ideal adjusted body weight was observed in patients with greater obesity, as well as in patients with diabetes. 5) In the general population, the developmental trend of toxicity during treatment was greater in the group dosed by actual body weight. 6) In the toxicity analysis by administered cycles, the dosed group by real body weight developed greater toxicity, reaching significant differences in thrombopenia, neutropenia, SGOT elevation and hyporexia. 7) Major diagnoses in the present study were ovarian cancer and non-small cell lung cancer. The effectiveness in terms of overall survival and progression-free survival, comparing the groups dosed by actual body weight and ideal adjusted body weight within each pathology did not show statistically significant differences.