Cisplatin 3 weekly or weekly

HelenBack
HelenBack Member Posts: 87 Member
in Head and Neck Cancer #1

I'm curious if your MO made a strong case in favor of one or the other. I wonder how many people were able to take the last of the 3 big doses. Our RO seems to think the weekly is better tolerated and just as effective, and she thinks our MO may make a case for the 3 big bags. it seems that studies show the results are comparable. 

Thanks,

Helen

Comments

  • phrannie51
    phrannie51 Member Posts: 4,716
    #2
    It feels like I'm seeing more people do

    the weekly chemo....I could be wrong.  Some start out doing the large dose, and can't tolerate it....so go into the weekly mode....and others do as your Onc is saying....the plan being for weekly from the start.  When I started treatment a year ago, it seemed I was hearing many who were doing the big dose every 3 weeks.  I'd think that one is as good as the other...and the weekly would be easier on the body.

    p

  • fishmanpa
    fishmanpa Member Posts: 1,227 Member
    #3
    The standard answer is....

    Everyone is different. I found an interesting study from Johns Hopkins on treating SCC H&N with an unknown primary. It presented three different cases and each one was different in it's approach to chemo and the drugs used. There were many factors to consider and all dictated a slightly different game plan as far as # of rads, chemo drugs used etc. Chemo drugs, especially when combined in "cocktails", can result in heart issues. For me, being that I have cardio vascular disease, Cisplatin is the least stressful on my heart and spacing it over 6 weeks reduces risks while not sacrificing the effectiveness. Mind you, that was in conjunction with the surgery beforehand. The team felt it best to remove the tumors and the cancer (as much as they could find) prior so the treatment would be more of a "mop up" operation. 

    "T"

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #4
    No Case...

    Mine made no case...Cisplatin (along with Taxotere and 5FU) in three big doses, three eeks apart. Then I had weekly Carboplatin for an additional seven weeks... But I didn't have any problems with any of the chemo, so no issues for me.

    JG

  • Ladylacy
    Ladylacy Member Posts: 773 Member
    #5
    Chemo

    My husband had the big dose of Cisplatin every 3 weeks.  He did have a problem mainly because he wasn't staying hydrated.  Effected his kidneys.  The last dose was divided into 2 weekly doses and he had no problems.  His second round of chemo was carboplatin every week for 7 treatments and the dose depended on his weight and how he was tolerating the chemo.

  • vermontgirl
    vermontgirl Member Posts: 66
    #6
    Weekly or 3 same results

    Originally, our MO planned for 3 CIS doses but when he found outs that my husband has hearing loss as a child in one ear.....sent him for hearing testing.  That confirmed loss but also said if there was more loss from CIS, he would still have functionally hearing.  So....MO opted for weekly CIS to be able to react quickly if any negative effects appeared.  He explained that if he gave a big dose and effects started to appear......there is nothing they can do to react....the meds are in.  but if negative effects happened on a smaller dose, they can React faster.  He is at Dana Farber and he said that there astudies is confirming no difference in prognostic outcobetween even 3 big doses or weekly.

  • corleone
    corleone Member Posts: 312 Member
    #7
    Sorry, I hit the send before I finished it

    Here is the full version:

    I was supposed to receive 3 high doses of Cisplatin every 3 weeks, during radiation, but I ended up receiving only 2, due to ototoxicity. Here’s a conclusion of an article that you can find at this link: http://www.ncbi.nlm.nih.gov/pubmed/18607863 :

    "Delivery of 100 mg/m(2) Cisplatin 3-weekly with radiotherapy was less tolerated than 40 mg/m(2) weekly and resulted in less patients achieving cumulative dose beyond 200 mg/m(2), potentially lowering chemotherapy dose intensity."

    On the other hand, another publication (http://www.biomedcentral.com/content/pdf/1748-717X-7-215.pdf ) reaches this conclusion:

    "Three-weekly high-dose cisplatin treatment showed higher compliance, and lower acute toxicity compared to weekly low-dose cisplatin treatment."

    So It’s up to anyone’s guess.

  • HelenBack
    HelenBack Member Posts: 87 Member
    #8
    corleone said:

    Sorry, I hit the send before I finished it

    Here is the full version:

    I was supposed to receive 3 high doses of Cisplatin every 3 weeks, during radiation, but I ended up receiving only 2, due to ototoxicity. Here’s a conclusion of an article that you can find at this link: http://www.ncbi.nlm.nih.gov/pubmed/18607863 :

    "Delivery of 100 mg/m(2) Cisplatin 3-weekly with radiotherapy was less tolerated than 40 mg/m(2) weekly and resulted in less patients achieving cumulative dose beyond 200 mg/m(2), potentially lowering chemotherapy dose intensity."

    On the other hand, another publication (http://www.biomedcentral.com/content/pdf/1748-717X-7-215.pdf ) reaches this conclusion:

    "Three-weekly high-dose cisplatin treatment showed higher compliance, and lower acute toxicity compared to weekly low-dose cisplatin treatment."

    So It’s up to anyone’s guess.

    I found both of those publications too.

    I understood that weekly doses are given to poeple with high risk for complications and that the big three-weekly doses are given to those who can "take it". That would likelybe my husband.

    We'll just see what the MO says tomorrow. My husband had multiple nodes, one with extracapsular spread and so I want to hit it as hard as possible. But if it's all the same, weekly sounds more do-able.

    Thanks for the reply,

    Helen

  • hwt
    hwt Member Posts: 2,328 Member
    #9
    HelenBack said:

    I found both of those publications too.

    I understood that weekly doses are given to poeple with high risk for complications and that the big three-weekly doses are given to those who can "take it". That would likelybe my husband.

    We'll just see what the MO says tomorrow. My husband had multiple nodes, one with extracapsular spread and so I want to hit it as hard as possible. But if it's all the same, weekly sounds more do-able.

    Thanks for the reply,

    Helen

    small doses

    I started out on the large dose but had to go everyday for a week to get fluids following the 1st dose. At the end,I was switched to the lessor dose more often and handled that o.k.  until the last tx. The ONC said I had a "free pass" on it because my counts were low.  Guess what I am trying to say is that you can change doses midstream if the larger is too difficult. I had lymph nodes involved also and one not capsulated. I will be a year out of tx come May and have been NED. Next scan is tomorrow.

  • D Lewis
    D Lewis Member Posts: 1,581 Member
    #10
    Compromise...

    Helen, I got the 'three big bags' of Cisplatin except my onco doc fractionated it.  Every chemo week, I got the bag infused over two days, rather than one. So - six days total; Monday and Tuesday of each chemo week.  He seemed to think I would tolerate it better that way.  It appears I did.

    Deb

  • HelenBack
    HelenBack Member Posts: 87 Member
    #11
    hwt said:

    small doses

    I started out on the large dose but had to go everyday for a week to get fluids following the 1st dose. At the end,I was switched to the lessor dose more often and handled that o.k.  until the last tx. The ONC said I had a "free pass" on it because my counts were low.  Guess what I am trying to say is that you can change doses midstream if the larger is too difficult. I had lymph nodes involved also and one not capsulated. I will be a year out of tx come May and have been NED. Next scan is tomorrow.

    Hey, Good Luck today.

    Fingers crossed for NED.

    Helen

Discussion Boards