Cisplatin, which has been a mainstay in the treatment of head and neck cancer, frequently is used to treat cancer of the head and neck. Its antitumor activity results from intracellular binding of the activated, positively charged form with a nucleophilic site on DNA to form bifunctional covalent links that interfere with normal DNA function (1). Cisplatin usually is administered over 2 to 6 hours in doses of 60 to 120 mg/m2, with similar efficacy reported for this entire dosage range. Renal toxicity is common and includes mild to moderate azotemia and electrolyte wasting, particularly of magnesium and potassium. Other toxic reactions include nausea and vomiting, peripheral neurotoxicity, ototoxicity, and cumulative myelosuppression if several cycles of the drug are administered. For single-agent doses ranging from 60 to 120 mg/m2 given every 3 to 4 weeks, partial response rates of approximately 15% to 30% are achieved.
Because of the toxicity of cisplatin, in particular its dose-limiting nephrotoxicity and neurotoxicity, analogues of the drug have been developed with the goal of preserving the antitumor activity of the drug and decreasing its toxic effects. Carboplatin has decreased nephrotoxicity and neurotoxicity. Its dose-limiting toxicity is myelosuppression. Another advantage of this compound is a comparable ease of administration. Because nausea and vomiting are reduced, carboplatin can be given easily on an outpatient basis and without vigorous hydration. It is active against cancer of the head and neck, but slightly less so than is cisplatin. Carboplatin is now commonly used, particularly in the palliative setting, in which minimizing side effects and hospital time is essential (14). An additional platinum compound, oxaliplatin, is currently in clinical trials for head and neck cancer.
Technorati Tags: Chemotherapy, Cisplatin, Carboplatin
Because of the toxicity of cisplatin, in particular its dose-limiting nephrotoxicity and neurotoxicity, analogues of the drug have been developed with the goal of preserving the antitumor activity of the drug and decreasing its toxic effects. Carboplatin has decreased nephrotoxicity and neurotoxicity. Its dose-limiting toxicity is myelosuppression. Another advantage of this compound is a comparable ease of administration. Because nausea and vomiting are reduced, carboplatin can be given easily on an outpatient basis and without vigorous hydration. It is active against cancer of the head and neck, but slightly less so than is cisplatin. Carboplatin is now commonly used, particularly in the palliative setting, in which minimizing side effects and hospital time is essential (14). An additional platinum compound, oxaliplatin, is currently in clinical trials for head and neck cancer.
Technorati Tags: Chemotherapy, Cisplatin, Carboplatin
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