• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3351-3354
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• 2015

Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric age group. All patients with RMS regardless of their initial stage or group receive combination chemotherapy as 'standard therapy' consisting of vincristine, actinomycin-D and cyclophosphamide. Actinomycin-D was not readily available in Turkey at one time. Carboplatin was used instead in order to prevent delays in treatment. The aim of this report is to present the results of patients with rhabdomyosarcoma receiving carboplatin or actinomycin-D therapy. Materials and Methods: Twenty four patients with rhabdomyosarcoma treated between December 2000 and June 2011 were included in this retrospective study. The patients were treated according to International Rhabdomyosarcoma Study Group guidelines. Eleven patients were treated with actinomycin-D and 13 with carboplatin ($250mg/m^2/dose$ for 2 days). The two groups were then compared in terms of 2- and 5-year overall survival (OS) and hematological and non-hematological toxicities. Results: Age, sex, stage and the mean duration of follow-up were similar in both groups (p>0.05). Two- and five-year OS levels were 68.2% in the carboplatin group and 78.0% and 40.0%, respectively, in the actinomycin-D group. There was no statistical difference in the number of febrile episodes (p=0.86) and no other hematological and non-hematological adverse effects were recorded in both groups. Conclusions: The findings show that carboplatin can be used as an alternative drug in the primary treatment of rhabdomyosarcoma in the event that actinomycin-D is unavailable or not tolerated.

• 대한한방부인과학회지
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• 제35권1호
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• pp.91-104
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• 2022

Objectives: The purpose of this study is to report the effect of combination treatment of Traditional Korean medicine (TKM) and chemotherapy on a ovarian cancer with lung metastasis patient. Methods: One ovarian cancer with lung metastasis patient was treated by TKM in conjunction with Carboplatin/paclitaxel since Feb. 2020. Repeat cycle every 3 weeks for 6 times. The patient has been treated with TKM at the same time. To evaluate the patient, symptoms were measured by Numeric Rating Scale (NRS), Eastern Cooperative Oncology Group (ECOG) and tumor size was measured by scanning with Computed Tomography (CT). Blood tests including cancer biomarker were conducted during treatment. Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), version 5.0. Results: After treatment with Carboplatin/paclitaxel and TKM during 2 months, the size of the ovarian cancer was decreased(Partial Response, PR), size and malignant pleural effusion at right lung disappeared. And no evidence of newly developed metastatic lesions. After 2 months, the tumor response was stable disease while improving the performance and other symptoms. Conclusions: This case provides us conjunctive treatment with Conventional and Eastern medicine may have substantial benefit for patients with end-stage ovarian cancer.

• 한국임상수의학회지
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• 제33권6호
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• pp.395-399
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• 2016

In the present case, the effect and toxicity of carboplatin and cyclophosphamide chemotherapy combined with surgery of mammary tumors in a dog were examined. An 8-year old spayed female Beagle presented with a mammary tumor. Physical examination, radiography, ultrasonography, computed tomography (CT), and laboratory examination were performed. Metastasis of the mammary tumor was confirmed by CT scan. Chemotherapy using a combination of carboplatin and cyclophosphamide was initiated following surgery. The first cycle of chemotherapy was planned to last for 6 weeks; it was planned that carboplatin would be intravenously administered for the first week (1 day) and cyclophosphamide would be intravenously administered for the next 3 weeks (22 days). Between the end of cycle 1 and the beginning of cycle 2, based on CT, it was confirmed that the number and size of tumors were unchanged and the tumors had not spread to other organs. However, at the end of cycle 2 and the beginning of cycle 3, CT revealed an increase in the number and size of mass in the lung. Chemotherapy was associated with adverse effects such as lethargy, anorexia, leukopenia, and hair loss. In conclusion, this case showed that a combination of carboplatin and cyclophosphamide suppressed the development of new neoplasms as well as metastasis for a certain period of time but did not improve the survival time. Although more cases are required, this chemotherapeutic procedure remains challenging.

• 한국임상약학회지
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• 제22권4호
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• pp.356-366
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• 2012

Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

• 한국임상수의학회지
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• 제28권3호
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• pp.314-317
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• 2011

체중이 4.3 kg인 중성화된 16세의 암컷 말티즈견이 약 2주 동안 누런색의 비강과 구강 분비물, 식욕부진과 기면 증상으로 내원하였다. 신체검사에서 구강내 왼쪽 혀 밑 부위에 약 $3{\times}3$ cm 크기의 궤양성 종괴, 심한 치은치주염, 구취, 중등도의 치석, 발열과 아래턱의 연조직 부종을 관찰하였다. 방사선 사진상에서 위턱과 아래턱의 앞 부위에서 골융해 소견을 볼 수 있었다. 총혈액검사와 혈액화학검사에서 혈소판수치, $NH_3$, AST와 ALP의 증가를 관찰할 수 있었으며, 요검사에서 혈뇨와 단백뇨가 나타났다. 조직검사결과 구강 편평 세포암으로 진단되었다. 축주의 거부로 외과적 처치는 실시하지 않았으며, 약물요법으로 carboplatin 주사와 piroxicam 구강내 투여를 병용하였다. 처음 약물투여 후 5일에 지속적인 구토 증상이 나타났으며, 이에 piroxicam을 meloxicam으로 대체하였으며 구토증상은 소실되었다. Meloxicam의 종양에 대한 치료효과에 대한 보고는 흔하지 않지만, 위장관계에 대한 부작용 발생은 piroxicam에 비해 낮음을 알 수 있었다. 이환견은 총 3회의 carboplatin 주사를 실시하였으나, 세 번째 주사 투여 후 5일에 심한 기면증상, 구토와 혈변 증상으로 내원하였고, 검사결과 심한 신기능부전 소견을 보였으며, 축주의 요구에 의해 안락사하였다.

• Clinical and Experimental Pediatrics
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• 제54권3호
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• pp.128-132
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• 2011

Purpose: Cisplatin-based chemotherapy has been commonly used for the treatment of intracranial germ cell tumors (IC-GCTs). However, this treatment exhibits some adverse effects such as renal problems and hearing difficulty. Carboplatin-based chemotherapy was administered to pediatric patients with IC-GCTs from August 2004 at the Samsung Medical Center. In this study, we assessed the responses and adverse effects of carboplatin-based chemotherapy in pediatric IC-GCTs patients according to the risk group, and compared the results with those of the previous cisplatin-based chemotherapy. Methods: We examined 35 patients (27 men and 8 women) diagnosed with IC-GCTs between August 2004 and April 2008 and received risk-adapted carboplatin-based chemotherapy at the Samsung Medical Center. Patients were divided into either low-risk (LR) or high-risk (HR) groups and a retrospective analysis was performed using information from the medical records. Results: Although hematological complications were common, hearing difficulties or grade 3 or 4 creatinine level elevation were not observed in patients who underwent carboplatin-based chemotherapy. The frequency of febrile neutropenia did not differ between the risk groups. The overall survival was 100% and event-free survival (EFS) was 95.7%. The EFS rate was 100% in the LR group and 90% in the HR group, respectively. Conclusion: Despite their common occurrence in high-risk patients, no lethal hematological complications were associated with carboplatin-based treatment. The current carboplatin-based chemotherapy protocol is safe and effective for the treatment of pediatric patients with IC-GCTs.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.81-85
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• 2012

Purpose: To study enhancing effects of paclitaxel in the thermochemotherapy of osteosarcoma cell lines and related mechanisms. Materials and Methods: Paclitaxel and carboplatin were used alone or jointly on OS732 cell lines in the presence of hyperthermia. Inhibition of proliferation was measured by MTT assay and cellular changes were assessed with inverted phase contrast and fluorescence microscopy. Apoptosis was analyzed with flow cytometry (FCM) and Fas expression by immunocytochemistry. Results: At $43^{\circ}C$, one hour after the application of 10ug/ml paclitaxel and $5{\mu}g/ml$ carboplatin on OS732 cells jointly, the survival rate was 15.8% which was significantly lower than with $10{\mu}g/ml$ paclitaxel (45.8%) and $5{\mu}g/ml$ carboplatin (47.7%) respectively (P<0.01). Moreover, changes of morphology and apoptotic rates indicated that the apoptosis-inducing effect of combined application was also much enhanced, as evident also regarding Fas expression. Conclusion: Paclitaxel is conducive to thermochemotherapy of osteosarcoma cell lines, possibly accomplished by up-regulation of Fas expression with induction of apoptosis.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1101-1106
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• 2013

Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.96.1-96.12
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• 2018

The 3-weekly regimen of carboplatin and paclitaxel is the backbone of first line adjuvant chemotherapy for advanced ovarian cancer. The landmark Japanese Gynaecologic Oncology Group (JGOG) 3016 study demonstrated significant improvements in progression-free survival and overall survival with dose dense weekly administration of paclitaxel in combination with 3-weekly carboplatin. However, efforts to replicate these benefits have failed in subsequent phase III trials. Weekly paclitaxel is purported to have enhanced antitumor activity, with stronger anti-angiogenic effects, and yet is better tolerated. In this review, we explore the rationale for dose dense weekly paclitaxel, and compare the relevant trials as well as quality of life considerations. Possible reasons for the difference in outcomes between the JGOG 3016 and other studies are reviewed, with a focus on how the addition of bevacizumab, the variations between histological and molecular subtypes of epithelial ovarian cancers, and ethnic pharmacogenetic differences may potentially affect the efficacy of dose dense paclitaxel.

• 한국임상수의학회지
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• 제28권6호
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• pp.603-606
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• 2011

11년 령의 중성화된 수컷 코커 스파니엘견이 구취, 식욕부진과 좌측 안면부의 부종 증상을 보여 내원하였다. 신체 검사 상에서 좌측 구강점막의 단단한 종괴가 확인되었다. 가는 침 흡인 세포검사 결과 악성의 중간엽 유래 종양이 가장 의심되어 생검을 실시하였고 조직검사 결과 섬유육종으로 진단되었다. 보호자의 거부로 수술적인 치료가 아닌 카보플라틴 (carboplatin, 300 $mg/m^2$, IV, q 21 days)을 이용한 항암치료를 실시하였다. 항암치료 시작 후 육안적으로 종양의 크기가 현저히 줄어들어 약 89일 후에는 육안적으로 완전 경감되었다. 총 4회의 항암치료 이후 항암치료를 중단하였고 종양의 재발은 일어나지 않았다. 본 증례보고는 개의 구강 섬유육종에서 carboplatin을 이용한 항암 치료가 육안적인 종양의 완전 경감을 유도할 수 있음을 보여준다.