Paclitaxel and carboplatin chemotherapy

This information is about a chemotherapy treatment using paclitaxel and carboplatin that is used to treat ovarian or lung cancer. Paclitaxel is also known as Taxol, so this chemotherapy treatment is sometimes called the TaxolCarbo regimen.

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The drugs that are used How treatment is given How often treatment is given Possible side effects Less common side effects Additional information References

The drugs that are usedBack to top

The treatment involves the two chemotherapy drugs, which are:

paclitaxel, which is commonly known as Taxol carboplatin.

How treatment is givenBack to top

Your chemotherapy treatment will be given to you as a day patient, or occasionally you may need to stay in hospital overnight. You will need to have a blood test before you start treatment either on the same day or a few days beforehand. You will also be seen by a doctor, specialist nurse or pharmacist. If the results of your blood test are normal, the pharmacy will prepare your chemotherapy drugs. This may take a couple of hours. The nurse will insert a thin, flexible tube (cannula) into a vein in your hand or arm. You may find this uncomfortable or a little painful but it shouldn't take long. Some people have their chemotherapy given through a thin, plastic tube inserted under the skin into a vein near their collarbone (central line) or passed through a vein in the crook of their arm (PICC line). Your doctor or nurse will explain more about this to you. Before the chemotherapy you will be given anti-sickness (anti-emetic) drugs, usually by injection through your cannula, central line or PICC line. Some anti-sickness drugs can be given as tablets. You will also be given medicines to prevent the allergic reaction that some people have when given paclitaxel. This anti-allergy medicine is often given by injection, but part of it is sometimes given as tablets that you take at home before coming to the hospital. It is very important to take the tablets, and you must tell your doctor or nurse if for any reason you haven't taken them. The chemotherapy drugs are then given separately:

paclitaxel (a colourless fluid) is given as a drip (infusion) over about three hours carboplatin (a colourless fluid) is also given as an infusion, over about one hour.

The whole treatment takes 45 hours. If you are having your treatment as a day patient you can then go home, and the cannula will be removed before you go. If you have a central or PICC line it will usually stay in place, ready for the next cycle of your chemotherapy. You will be shown how to look after the line. You will be given a supply of anti-sickness drugs to take home with you. You should take these regularly as directed, even if you aren't feeling sick. This is because some anti-sickness drugs are much more effective at preventing sickness than stopping it once it starts.

How often treatment is givenBack to top

Your doctor may use the word 'regimen' (eg the TaxolCarbo regimen) when talking about your chemotherapy. This means the whole plan or schedule of your particular chemotherapy treatment.

On the first day of treatment you will be given paclitaxel and carboplatin, as described, for one day only. After this, you will have a rest period with no chemotherapy for the next three weeks. This completes what is called a cycle of your treatment. After the rest period the same treatment is repeated, which begins the next cycle of your chemotherapy. Usually 68 cycles are given over a period of 56 months. This makes up a course of treatment.

Possible side effectsBack to top

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described below won't affect everyone who has treatment with paclitaxel and carboplatin. We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed below, discuss them with your doctor, chemotherapy nurse or pharmacist. Lowered resistance to infection (neutropenia) This treatment can reduce the number of white blood cells produced by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment and your resistance to infection usually reaches its lowest point 1014 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due. Contact your doctor or the hospital straight away if:

your temperature goes above 38C (100.4F) you suddenly feel unwell, even with a normal temperature.

You will have a blood test before having more chemotherapy to make sure that your number of white blood cells has recovered. Occasionally it may be necessary to delay treatment if your number of blood cells (blood count) is still low. Bruising or bleeding Paclitaxel and carboplatin chemotherapy can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. Anaemia (low number of red blood cells) You may become anaemic while having this treatment. This may make you feel tired and breathless. Tell your doctor or nurse if you have these symptoms. Feeling sick (nausea) and being sick (vomiting) Your doctor can prescribe very effective anti-sickness (antiemetic) drugs to prevent, or greatly reduce, nausea and vomiting. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective. Some anti-sickness drugs may cause constipation. Let your doctor or nurse know if this is a problem. Tiredness You may feel extremely tired (fatigued), particularly towards the end of treatment. This is a very common side effect and it is important to allow yourself plenty of time to rest. Hair loss This usually starts 34 weeks after the first course of treatment and is due to paclitaxel. Hair usually falls out completely. You may also have thinning and loss ofeyelashes, eyebrows and other body hair. This is temporary and your hair will start to grow back once the treatment has finished. Your nurse can give you advice about coping with hair loss. Sore mouth and ulcers Your mouth may become sore or dry, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicine to prevent or clear mouth infections. Diarrhoea This may occur several days after the treatment. This can usually be easily controlled with medicine but tell your doctor if it is severe or continues. It is important to drink plenty of liquids (23 litres a day) if you have diarrhoea. Numbness or tingling in hands or feet This is due to the effect of paclitaxel or carboplatin on the nerves and is known as peripheral neuropathy. Tell your doctor if you notice these symptoms or have difficulty with fiddly tasks. This problem usually improves slowly a few months after treatment is over. Aching joints and muscles You may have these symptoms a few days after treatment, due to the paclitaxel. This does not usually last long and your doctor can prescribe mild painkillers to help.

Allergic reaction Signs of an allergic reaction include skin rashes and itching, a high temperature, shivering, dizziness, a headache and breathlessness. You will be given medicine (a steroid) before treatment to reduce the chance of this happening. It is important to take the steroids as directed. Let your nurse or doctor know if you have any of these signs.

Less common side effectsBack to top

Headaches Some people find that paclitaxel causes headaches. Let your doctor know if this happens to you. Taste changes You may notice that food tastes different. Normal taste usually comes back after treatment finishes. Changes in hearing This is very rare if you have standard doses of the drug, but if you have high-dose treatment you may have ringing in the ears (tinnitus) and you may lose the ability to hear some high-pitched sounds. This side effect usually decreases when the treatment ends. Tell your doctor if you notice any tinnitus or loss of hearing. Changes in heart rate Paclitaxel can sometimes cause a temporary slowing of the heart rate, known as bradycardia. This does not usually cause any harm. Effect on your kidneys This is a rare side effect and unlikely to cause any symptoms. The function of your kidneys will be checked by a blood test before each treatment. Sometimes a 24-hour urine test is also carried out. Abdominal pain This may start a few days after having paclitaxel and last for a few days. Your doctor can prescribe regular painkillers if necessary. Always let your doctor or nurse know about any side effects that you have. There are usually ways in which they can be controlled or improved.

Additional informationBack to top

Risk of blood clots Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious, so it is important to tell your doctor straight away if you have any of these symptoms. Most clots can be treated with drugs that thin the blood. Your doctor or nurse can give you more information. Other medicines Some medicines, including those you can buy in a shop or chemist, can be harmful to take when you are having chemotherapy. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapiesand herbal drugs. Fertility Your ability to become pregnant or father a child may be affected by this treatment. It's important to discuss fertility with your doctor before starting treatment. Contraception It's not advisable to become pregnant or father a child while taking this treatment, as it may harm the developing baby. It is important to use effective contraception while taking these drugs and for at least a few months afterwards. You can discuss this with your doctor. Loss of periods in women Due to the effect of chemotherapy on the ovaries, you may find that your periods become irregular, and they may eventually stop. In some women, this may be temporary, but for others it may be permanent. If your periods stop permanently, this will result in menopausal symptoms such as hot flushes and sweats.

ReferencesBack to top
This section is based on our paclitaxel and carboplatin fact sheet, which has been compiled using information from a number of reliable sources including:

Sweetman, et al. Martindale: The Complete Drug Reference. 36th edition. 2009. Pharmaceutical Press. British National Formulary. 58th edition. 2009. British Medical Association and Royal Pharmaceutical Society of Great Britain. Perry MC. The Chemotherapy Source Book. 4th edition. 2007. Lippincott, Williams and Wilkins.

For further references, please see the general bibliography.

Carboplatin termasuk dalam kelompok obat yang dikenal dengan alkylating agents, yaitu obat yang digunakan untuk mengobati kanker indung telur. Namun carboplatin juga dapat digunakan untuk mengobati jenis kanker lainnya sesuai petunjuk dokter tentunya. Carboplatin mengganggu pertumbuhan dan kemudian menghancurkan sel kanker. Carboplatin hanya boleh diberikan di bawah pengawasan langsung dari dokter. Carboplatin digunakan pada pasien tertentu dengan kondisi medis berikut: 1. Kanker kandung kemih 2. Kanker payudara 3. Kanker kerongkongan 4. Kanker tuba fallopi atau selaput perut (menyebar dari ovarium) 5. Kanker kepala dan leher 6. Kanker pada testis 7. Kanker sistem getah bening 8. Kanker paru-paru 9. Kanker endometrium (lapisan rahim) 10. Melanoma maligna (jenis kanker kulit) 11. Retinoblastoma (jenis kanker mata) 12. Tumor pada otak 13. Kanker yang tidak diketahui asalnya Kemasan Produk ini tersedia dalam bentuk sediaan bubuk untuk larutan, larutan Dosis Obat ini kadang-kadang diberikan bersama dengan obat-obatan tertentu lainnya. Dosis obat ini akan berbeda untuk pasien yang berbeda, tergantung pada instruksi dokter. Efek Samping 1. Mual dan muntah 2. Kelelahan atau lemahan 3. Sembelit atau diare 4. Kehilangan nafsu makan
4. Mitotic Spindle Golongan obat ini berikatan dengan protein mikrotubuler sehingga menyebabkan disolusi struktur mitotic spindle pada fase mitosis. Antara lain: - Plakitaxel (Taxol) - Vinorelbin - Docetaxel - Vindesine - Vinblastine - Vincristine