Weekly carboplatin reduces toxility during synchronous chemotherapy for merkel cell carcinoma of skin

Poulsen, Michael, Walpole, Euan, Harvey, Jennifer, Dickie, Graeme, O'Brien, Peter, Keller, Jacqui, Tripcony, Lee and Rischin, Danny (2008) Weekly carboplatin reduces toxility during synchronous chemotherapy for merkel cell carcinoma of skin. International Journal of Radiation Oncology Biology Physics, 72 4: 1070-1074. doi:10.1016/j.ijrobp.2008.02.076


Author Poulsen, Michael
Walpole, Euan
Harvey, Jennifer
Dickie, Graeme
O'Brien, Peter
Keller, Jacqui
Tripcony, Lee
Rischin, Danny
Title Weekly carboplatin reduces toxility during synchronous chemotherapy for merkel cell carcinoma of skin
Journal name International Journal of Radiation Oncology Biology Physics   Check publisher's open access policy
ISSN 0360-3016
1879-355X
Publication date 2008-11-15
Year available 2008
Sub-type Article (original research)
DOI 10.1016/j.ijrobp.2008.02.076
Open Access Status
Volume 72
Issue 4
Start page 1070
End page 1074
Total pages 5
Editor J. D. Cox
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Subject 920102 Cancer and Related Disorders
111204 Cancer Therapy (excl. Chemotherapy and Radiation Therapy)
Abstract Purpose: The toxicity of radiotherapy (RT) combined with weekly carboplatin and adjuvant carboplatin and etoposide was prospectively assessed in a group of patients with high-risk Stage I and II Merkel cell carcinoma of the skin. This regimen was compared with the Trans-Tasman Radiation Oncology Group 96:07 study, which used identical eligibility criteria but carboplatin and etoposide every 3 weeks during RT.
Formatted abstract
Purpose
The toxicity of radiotherapy (RT) combined with weekly carboplatin and adjuvant carboplatin and etoposide was prospectively assessed in a group of patients with high-risk Stage I and II Merkel cell carcinoma of the skin. This regimen was compared with the Trans-Tasman Radiation Oncology Group 96:07 study, which used identical eligibility criteria but carboplatin and etoposide every 3 weeks during RT.

Patients and Methods

Patients were eligible if they had disease localized to the primary site and lymph nodes, with high-risk features. RT was delivered to the primary site and lymph nodes to a dose of 50 Gy and weekly carboplatin (area under the curve of 2) was given during RT. This was followed by three cycles of carboplatin and etoposide. A total of 18 patients were entered into the study, and their data were compared with the data from 53 patients entered into the Trans-Tasman Radiation Oncology Group 96:07 study.

Results

Involved lymph nodes (Stage II) were present in 14 patients (77%). Treatment was completed as planned in 16 patients. The weekly carboplatin dose was delivered in 17 patients, and 15 were able to complete all three cycles of adjuvant carboplatin and etoposide. Grade 3 and 4 neutrophil toxicity occurred in 7 patients, but no cases of febrile neutropenia developed. Compared with the Trans-Tasman Radiation Oncology Group 96:07 protocol (19 of 53 cases of febrile neutropenia), the reduction in the febrile neutropenia rate (p = 0.003) and decrease in Grade 3 skin toxicity (p = 0.006) were highly statistically significant.

Conclusion

The results of our study have shown that weekly carboplatin at this dosage is a safe way to deliver synchronous chemotherapy during RT for MCC and results in a marked reduction of febrile neutropenia and Grade 3 skin toxicity compared with the three weekly regimen.

Keyword Carboplatin
Chemoradiotherapy
Etoposide
Merkel cell carcinoma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 15 August 2008.

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Fri, 17 Apr 2009, 18:00:39 EST by Sarah Elliott on behalf of Royal Brisbane Clinical School