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Subodh Kamble, Vasdev N, Dadhania S, Hawkins A, Hall M, Gogbashian A, Rustin G, Sharma A
These authors contributed equally to this work. Mount Vernon Cancer Centre, Northwood, UK Paul Strickland Scanner Centre, Northwood,UK Lister Hospital, Northwood, UK Sanjeevani Hospital, India
Posters & Accepted Abstracts: Clin Nephrol Res
Background: We studied the efficacy, safety and tolerability of dose dense Carboplatin AUC10 chemotherapy and explored the HRQoL (Health-Related Quality of Life) in metastatic seminoma patients receiving this regimen. Methods: 46 patients with metastatic seminoma treated with Carboplatin AUC10 were identified in our centre. Carboplatin dosing at AUC 10 was used and calculated based on the Calvert formula and EDTA clearance. Treatment was administered as a single dose every 21 days for 3 or 4 cycles. Response to treatment was determined by radiological imaging and serum tumour markers. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. Quality of Life (QOL) and long-term treatment related toxicities were assessed post treatment using a self-designed telephonic questionnaire consisting of 4 questions about toxicity, which included- hair loss, hearing impairment, day’s absence from work and neuropathy. Results: Clinical characteristics are as follows: median age was 44 (range 26-77), 44 patients had stage II and 2 had stage III seminoma; average dose of carboplatin administered was 1240mg per cycle (620mg/m2). 4.3% patients received 2, 87% 3 and 8.7% 4 cycles of chemotherapy. 93% of patients achieved a Complete Remission (CR), 4 (all stage IIC) patients required a fourth cycle of chemotherapy, two undergoing RPLND and two watchful waiting. There was no disease relapse at median follow-up of 27.5 (range 4-84) months. 13 patients (28%) experienced grade 3 and 2 (4%) grade 4 neutropenia, thirteen (28%) grade 3/4 thrombocytopenia, Nine (19.5%) patients required prophylactic filgrastim. Commonest non-haematological toxicities were fatigue in 28 (50%) and nausea 14 (28%) patients. QOL data was available for 35/46 (76%) of patients. 40/46 (87%) patients had no residual tinnitus. One patient had residual grade 1 peripheral neuropathy. Eight patients continued to work throughout treatment, 16(45%) patients took <5 days off work during chemotherapy, 4 patients took between 5 to 21 days, 13 more than 21 days and two were retired. Keywords: Testicular cancer, Carboplatin, AUC10, Toxicity, HRQOL. Recent Publications 1. Meddings, Jennifer A et al. “Effect of nonpayment for hospital-acquired, catheter-associated urinary tract infection: a statewide analysis.” Annals of internal medicine vol. 157,5 (2012): 305-12.
Subodh Kamble is a Urologist, Uro-Onco, and Robotic Surgeon doctor at Sanjeevani Multispecialty Hospital Vesu Surat. He graduated from India from Shah Mahavir Super Speciality Hospital. He completed his masters in the United Kingdom from the University of Edinburgh.
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