3차 병원에서 환자의 신기능에 따른 카보플라틴 용량의 적절성 및 부작용에 대한 패턴분석

Abstract

Carboplatin is an alkylating agent mainly used to treat ovarian and lung cancers. It is mostly eliminated by the kidney (about 70%); therefore, the dosing of carboplatin is determined by the renal function of individual patient. However, studies related to carboplatin dosing appropriateness by the renal function of individual patient have rarely been conducted in Korea. The goals of this study were to analyze carboplatin dosing appropriateness and adverse reaction patterns. The retrospective study was conducted between September 2011 and August 2013 in a tertiary hospital. The mean percent error (MPE) was utilized to compare actual carboplatin dose with estimated carboplatin dose. According to the National Cancer Institute-Common Toxicity Criteria (NCI-CTC) 3.0, the severity of adverse reactions was graded, and the examination of adverse reactions were followed up until 4 weeks after administering last dose of carboplatin in the period of chemo-cycle. A total of 239 patients was chosen to analyze carboplatin dosing appropriateness. As a result, there was no statistically significant difference between actual and estimated carboplatin doses (p=0.503); however, MPE showed statistically significant correlation with each chemotherapy regimen administered (p<0.001). One hundred fifty four patients who met inclusion criteria were also selected to analyze the adverse reaction patterns. MPE showed the association with statistically significant patterns over the adverse reactions after carboplatin administration (p<0.05), and these were statistically significant based on each chemotherapy regimen administered (p<0.05). Further related studies are needed to confirm this study since it was conducted in only single hospital as well as to better optimize chemotherapy of carboplatin and decrease related adverse reactions based on MPE.