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Dose adjustment of carboplatin in patients on peritoneal dialysis

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Abstract

The Calvert equation has been extensively used to determine the dosage of carboplatin. However, in patients on dialysis, it predicts the same dosage regardless of the frequency of dialysis. Clearance of carboplatin during hemodialysis has been studied to a lesser extent, but there have been very few studies which have investigated the clearance of carboplatin in patients on peritoneal dialysis. A mathematical formula is proposed here to predict the dose of carboplatin for a given AUC in patients on peritoneal dialysis. This formula takes into account the frequency of dialysis sessions and the time delay between carboplatin infusion and the initiation of dialysis. The formula predicts an approximately similar dosage of carboplatin as that of the Calvert formula in patients undergoing peritoneal dialysis four times per day if dialysis is initiated 12 h after infusion. The formula may help in guiding the adjustment of carboplatin dose in patients who receive a lesser number of dialysis sessions per day and in those patients whose dialysis is initiated at different times (0–24 h) after carboplatin infusion. It is suggested that usage of this formula will result in a better dosage of carboplatin to suit specific dialysis frequencies in specific patients and eventually may result in a better efficacy and toxicity profile.

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Authors and Affiliations

  1. Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, 50 Fruit Street, Boston, MA, 02114, USA

    Achuta K. Guddati

  2. Department of Internal Medicine, University of Iowa Hospitals and Clinics, University of Iowa, Iowa, IA, 52242, USA

    Parijat S. Joy

  3. Division of Pulmonary Medicine, Department of Medicine, Tahlequah City Hospital, Tahlequah, OK, 74464, USA

    Creticus P. Marak

Authors
  1. Achuta K. Guddati
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  2. Parijat S. Joy
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  3. Creticus P. Marak
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Corresponding author

Correspondence to Achuta K. Guddati.

Additional information

An abstract describing this work with similar results has been submitted to ASCO, 2014.

Appendix 1

Appendix 1

See Tables 3, 4.

Table 3 The adjusted dose of carboplatin for patients receiving peritoneal dialysis assuming a clearance of 15 % and for a total of 20 dialysis sessions is shown below
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Table 4 The adjusted dose of carboplatin for patients receiving peritoneal dialysis assuming a clearance of 20 % and for a total of 20 dialysis sessions is shown below
Full size table

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Guddati, A.K., Joy, P.S. & Marak, C.P. Dose adjustment of carboplatin in patients on peritoneal dialysis. Med Oncol 31, 946 (2014). https://doi.org/10.1007/s12032-014-0946-z

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  • DOI: https://doi.org/10.1007/s12032-014-0946-z

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