Cycle length: Carboplatin and paclitaxel are each given weekly for five weeks with concurrent RT followed by surgery. | |||
Drug | Dose and route | Administration | Given on days |
Paclitaxel | 50 mg/m2 IV | Dilute in 250 mL NS* and administer over one hour; special tubing needed.¶ | Days 1, 8, 15, 22, and 29 |
Carboplatin | AUCΔ = 2 mg/mL × min IV | Dilute in 250 mL NS* and administer over 30 minutes after paclitaxel. | Days 1, 8, 15, 22, and 29 |
Pretreatment considerations: | |||
Emesis risk |
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Prophylaxis for infusion reactions |
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Vesicant/irritant properties |
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Infection prophylaxis |
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Dose adjustment for baseline liver or kidney dysfunction |
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Monitoring parameters: | |||
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Suggested dose modifications for toxicity: | |||
Myelotoxicity/neurologic toxicity |
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Kidney toxicity |
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If there is a change in body weight of at least 10%, doses should be recalculated. |
ANC: absolute neutrophil count; AUC: area under the concentration × time curve; CBC: complete blood count; GFR: glomerular filtration rate; G-CSF: granulocyte colony stimulating factor; IV: intravenous; NCCN: National Comprehensive Cancer Network; NS: normal saline; RT: radiotherapy.
* Diluent solutions should not be modified without consulting a detailed reference due to potential incompatibility(ies).
¶ Paclitaxel can be administered in NS, D5W, or NS/D5W* at varying concentrations between 0.3 to 1.2 mg/mL. Use glass or polypropylene bottles or polypropylene or polyolefin plastic bags, and administer through a polyethylene-lined administration sets with a microporous membrane 0.22 microns or less.
Δ AUC is converted to a patient-specific carboplatin dose (in mg) according to renal function by using the Calvert formula: Total dose (mg) = (target AUC) × (GFR + 25). If using measured creatinine, limit the maximal GFR for the calculation to 125 mL/min. Refer to UpToDate topics on dosing of anticancer agents in adults.
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