The modern look on the platinum-based chemotherapy effectiveness the modern look on the platinum-based chemotherapy effectiveness

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Rybin A. I. The mode n look on he pla inum-based chemo he apy e ec i eness he mode n look on he pla inum-based
chemo he apy e ec i eness. Jou nal o Educa ion, Heal h and Spo . 2025;81:66051. eISSN 2391-8306.
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UDK 618.11-006.6-085.28.036.8
THE MODERN LOOK ON THE PLATINUM-BASED CHEMOTHERAPY
EFFECTIVENESS
A. I. Rybin
Odessa Na ional Medical Uni e si y, Odessa, Uk aine
Rybin A. I., ORCID: 0000-0002-1145-6690, e-mail: And [email protected]
Abs ac
The aim o he wo k is o assess he quali y o li e in pla inum- esis an pa ien s wi h
o a ian cance , depending on he deg ee o pha maco esis ance and di e en ia ed use o
chemo he apy.
Ma e ials and me hods. The s udy was conduc ed on he basis o he Uni e si y
Clinic o he Odessa Na ional Medical Uni e si y du ing 2014 - 2020 yea s. 350 pa ien s wi h
adenoca cinoma o he o a ies o III-IV s age we e examined, who pe o med cy o educ i e
ope a ions.
Resul s and discussion. I is shown ha he ini ial alues on he subscales o he
ques ionnai es EORTC QLQ-C30 and FACT-G in pa ien s classi ied as di e en clinical
g oups we e compa ed. When using a di e en ia ed app oach in he ea men o pa ien s wi h
OC, he indica o s on he scales o physical (PF), ole (RF) and emo ional unc ioning (EF)
we e signi ican ly imp o ed. In addi ion, he in ensi y o nausea (NV) and gene al weakness
2
(FA) dec eased in pa ien s o g oups III and IV. In he case o di e en ia ed use o
chemo he apeu ic agen s wi h me abolic suppo , he o al sco e acco ding o he FACT-G
ques ionnai e was 77.80.9 poin s in g oup III, and 77.90.8 poin s in g oup IV, which
signi ican ly exceeds he ecei ed in I and II g oups - 72.21,2 and 71,60,9 poin s. The
desc ibed di e ences we e kep h oughou he pe iod o ca amnes ic obse a ion.
Conclusions: The use o a di e en ia ed app oach in he ea men o pa ien s wi h RI
signi ican ly imp o ed indica o s on he scales o physical (PF), ole (RF) and emo ional
unc ioning (EF). A e ea men , he in ensi y o nausea (NV) and gene al weakness (FA)
dec eased in pa ien s o g oups III and IV. The desc ibed di e ences we e e ained o 12
mon hs a e he comple ion o he cou se o ea men . P ospec s o u he esea ch a e
ela ed o he s udy o he dynamics o li e quali y o pa ien s wi h OC a he subsequen
s ages o ca amnes ic obse a ion.
Key wo ds: o a ian cance ; ea men ; chemo he apy; pla ino esis ance;
pla ino e ac ion; quali y o li e
In oduc ion. Malignan o a ian umo s emain one o he main causes o dea h in
oncogynecological p ac ice. In he wo ld, mo e han 200000 women a e diagnosed wi h
o a ian cance (OC) e e y yea and 100000 women die o his disease e e y yea . The
in a i al isk o o a ian cance is assessed by expe s as 1/70 [1- 4].
Mos o en, o a ian cance is diagnosed in women aged 55-64 yea s. OC incidence
anges om 3.1 cases pe 100000 women in Japan o 21 cases pe 100000 women in Sweden.
In gene al, he highes incidence a es a e inhe en in he coun ies o Scandina ia, Ge many,
Benelux, G ea B i ain, Canada and he Uni ed S a es. Ins ead, in Asian coun ies, OC is
much less common, as well as among immig an s om Asian coun ies in he economically
de eloped coun ies o Eu ope and No h Ame ica. The Hippisley-Cox-Coupland model
desc ibes he isk o RI occu ence, acco ding o which wo- hi ds o cases occu wi hin 2
yea s in 10% o women wi h he highes isk o de eloping RI [5-9]. A he same ime,
in e ili y and childlessness, ea ly mena che and la e menopause, he use o o al
con acep i es, a bu dened he edi a y his o y o o a ian and b eas umo s, long- e m
ho mone he apy, lac ose consump ion and occupa ional haza ds a e he isk ac o s
associa ed wi h he in luence o ca cinogens and mu agens.
In gene al, he p oblem o OC has conside able medical and social signi icance. Only
in ecen yea s, some p og ess has been made in inc easing he i e-yea su i al a e o
pa ien s wi h RI, mainly due o he in oduc ion o e ec i e chemo he apy egimens [10].
3
Howe e , abou 40% o pa ien s a e p ima y- esis an o pla inum p epa a ions, which a e
conside ed as i s -line d ugs. Depending on he iming o disease p og ession dis inguish
pla inosensi i e umo s (p og ess mo e han 6 mon hs a e i s -line he apy), pla ino-
esis an (p og ess wi hin 6 mon hs a e i s -line he apy) and pla ino e ac o y (p og ess
du ing i s -line chemo he apy wi h inclusion o pla inum p epa a ion) [11-14]. A he same
ime, he unc ional assessmen o he e ec o an i umo he apy in pa ien s wi h RI on he
quali y o li e un il ecen ly was gi en insu icien a en ion.
The quali y o li e (QL) oday is conside ed as one o he mos in o ma i e indica o s
cha ac e izing he deg ee o adap a ion o a pe son o li ing condi ions and he gene al s a e o
his heal h and allow o de e mine he need o medical and psychosocial adap a ion. In ecen
yea s, he s udy o heal h ela ed quali y o li e, HRQL, has de eloped as a sepa a e medical
science, which has i s own esea ch me hods, e alua ion c i e ia, scope, e c. I is based on he
de ini ion o he Wo ld Heal h O ganiza ion (WHO) as an indi idual co ela ion o i s
posi ion in communi y li e in he con ex o cul u e and sys em o alues o socie y wi h he
goals o his indi idual, i s plans, oppo uni ies and deg ee o gene al disa angemen [15-19].
Tha is, a pe son's pe cep ion o his posi ion in li e, including physical, men al and social
well-being, ega dless o he quali y o he en i onmen in which he li es, he deg ee o
sa is ac ion wi h a speci ic s anda d o li ing and o he componen s o psychological com o
[20-23].
One o he mos popula ins umen s o de e mining YES in oncological p ac ice is a
ques ionnai e o he Eu opean O ganiza ion o Resea ch and Cance T ea men - EORTC
QLQ-C30 - de eloped by he Quali y o Li e Assessmen G oup o he Eu opean
O ganiza ion o Resea ch and T ea men o Cance (EORTC Quali y o Li e S udy G oup)
[24, 25]. The mode n e sion o he 3 d e ision consis s o 30 issues and includes 5
unc ional scales (physical unc ioning (PF), ole unc ioning (RF), cogni i e unc ioning
(CF), emo ional unc ioning (EF) and social unc ioning (SF); 3 symp oma ology scales -
weakness (FA), nausea (NV) and pain (PA ); as well as 6 addi ional c i e ia: sleep dis u bance
(SL), ano exia (AR), cons ipa ion (CO), dia hea (DI), dyspnea (DY), inancial di icul ies
(FI). Ano he popula diagnos ic ool is a ques ionnai e o e alua ing he unc ions o an
oncological pa ien , Func ional Assessmen o Cance The apy-Gene al (FACT-G) -
de eloped by D. Gellae al. [26]. The mode n e sion o FACT-G includes 27 ques ions and
assesses he quali y o li e on 4 scales: physical, social, emo ional unc ioning and well-being
in e e yday li e.Bo h ques ionnai es (EORTC QLQ-C30 and FACT-G) a e modula , i.e.
include a basic ques ionnai e o which speci ic ques ion aking in o accoun his o ha ype
4
o umo o ea men p og am. Howe e , he e is s ill no s udy in which o analyze he
cha ac e is ics o QL in pa ien s wi h OC wi h a ying deg ees o sensi i i y o pla inum
p epa a ions.
The aim o he wo k is o assess he quali y o li e in pla inum- esis an pa ien s wi h
o a ian cance , depending on he deg ee o pha maco esis ance and di e en ia ed use o
chemo he apy.
Ma e ial and me hods o esea ch
The s udy was conduc ed on he basis o he Uni e si y Clinic o he Odessa Na ional
Medical Uni e si y du ing 2014 - 2022 yea s. 350 pa ien s wi h adenoca cinoma o he
o a ies o III-IV s age we e examined, who pe o med cy o educ i e ope a ions, and o which
he ollowing clinical g oups we e o med: g oup I (con ol, n=50) — pa ien s wi h RI who
ecei ed s anda d i s -line adju an chemo he apy (cispla in — 75-100 mg/m 2 in a enously
wi h hyd a ion and diu esis o med e e y 3 weeks); G oup II (n=100) - pa ien s wi h p obable
pla ino e ac ion who ecei ed second-line he apy (doxo ubicin — 75-100 mg/m2
in a enously d ople s once e e y h ee weeks); G oup III (n=100 ) — pa ien s wi h p obable
pla ino esis ance who ecei ed d ug co ec ion o dis egula o y diso de s agains he
backg ound o s anda d i s -line he apy (dona o s o ni ic oxide, de oxican s, an iu icemic
agen s); G oup IV (n=100) — pa ien s wi h p edic ed pla inosensi i i y (s anda d he apy o
he i s lines a e he p e ious p e en i e cou se: 20 mg dexome hasone o 12 and 6 hou s
be o e he adminis a ion o pla inum p epa a ions, 300 mg cime idine o 50 mg ani idine and
50 mg o dimed ol o 30-60 minu es. Examina ion o pa ien s was ca ied ou in acco dance
wi h he equi emen s o he clinical p o ocol app o ed by he o de o he Minis y o Heal h
o Uk aine № 554 om 17.09.2007 “On app o al o p o ocols o medical ca e in he special y
“oncology" ” [1]. Addi ionally, QL was de e mined using s anda d ques ionnai es EORTC
QLQ-C30 and FACT-G [12]. QL was examined 6 and 12 mon hs a e he comple ion o
ea men .De e mina ion o he p obabili y o di e ences be ween he compa ed g oups was
ca ied ou using c i e ion 2, aking in o accoun he Ye s amendmen o pai ed compa isons
and Bon e oni co ec ions o mul iple compa isons. S a is ical p ocessing was ca ied ou
using so wa e STATISTICA 13.0 (Dell S a So Inc., USA) [4].
Resul s and hei discussions
I was es ablished ha pa ien s o di e en age g oups did no di e , he a e age age
in g oups was 55.33.9 yea s. The s uc u e o he g oups by s age o OC also did no di e ,
pa ien s wi h s age IIIS p e ailed - on a e age he e we e 64.9% in he o al sample (Fig. 1).
The clinical pic u e o he disease was s e eo ypical. Mos pa ien s complained o bloa ing and
5
discom o in he lowe abdomen, a eeling o p essu e in he bladde and ec um,
cons ipa ion. E e y en h o he examined woman had aginal bleeding. Dyspep ic
mani es a ions, sho ness o b ea h, gene al weakness, a igue, weigh loss o hawed and a
eeling o apid sa u a ion when consuming a small amoun o ood we e equen . 12.6% o
pa ien s had swelling o he lowe ex emi ies, 5.4% had signs o asci es. A he same ime,
17.4% o pa ien s we e no accompanied by subjec i e mani es a ions and was diagnosed
du ing ul asonog aphic sc eening.
Figu e 1 S uc u e o he s udied clinical g oups acco ding o he s age o OC
Du ing ul asound, mul ilocula dense hype echoic o ma ions la ge han 10 cm and
inc eased in a-o a ian blood low we e de e mined. In biochemical sc eening, high igu es o
CA-125 con en we e de e mined in 44.6% o he su eyed, which does no allow o conside
his me hod as qui e speci ic o he needs o ea ly diagnosis o OC.
Du ing he pe iod o ea men in di e en clinical g oups, pa ien s made complain s
o nausea, as e diso de s, immedia ely be o e ea ing, dizziness, gene al weakness. 6.0% o
pa ien s e e ed o he con ol g oup and 2.0% o pa ien s g oup IV had isual impai men . In
one case, he pa ien had signs o pe iphe al polyneu opa hy and Le mi symp om. Fo he
gene al analysis o blood on he backg ound o he apy wi h pla inum p epa a ions, he e we e
signs o mode a e leukopenia, and a leas anemia. A equen occu ence was a e ial

6
hypo ension. Du ing ea men , pa ien s o g oup I and IV also complained o cough,
e y hema ous ash, and ex a asa es a he injec ion si e.
As o pa ien s o g oup II, agains he backg ound o he apy wi h doxo ubicin, hey
de e mined signs o sub eb ile, palpi a ion, h ombocy openia and leukopenia, nausea,
omi ing, signs o s oma i is, dia hea. A he beginning o ea men , pa ien s o g oup II
no ed a change in he colo o u ine wi h he appea ance o a eddish hue. Common
phenomenon was alopecia, da kening o soles and palms, some imes - palma e y hema,
changes in he shape o nails, skin i ching and ash. Indi idual pa ien s de e mined he
phenomena o pho ophobia and enla ged lac ima ion by he ype o epipho us. The leas
numbe o subjec i e complain s du ing ea men was obse ed in pa ien s o g oups III and
IV who ecei ed pa hogene ically condi ioned me abolic suppo complex.
Fu he analysis showed ha he ini ial alues o he subscales o he ques ionnai es
EORTC QLQ-C30 and FACT-G in pa ien s assigned o di e en clinical g oups we e
compa ed (Table 1 and 2). Howe e , du ing epea ed isi s a he ca amnes ic s age, ce ain
di e ences we e de e mined a he le el o QL. When using a di e en ia ed app oach in he
ea men o pa ien s wi h OC, he indica o s on he scales o physical (PF), ole (RF) and
emo ional unc ioning (EF) we e signi ican ly imp o ed. In addi ion, he in ensi y o nausea
(NV) and gene al weakness (FA) dec eased in pa ien s o g oups III and IV. The desc ibed
di e ences we e kep h oughou he pe iod o ca amnes ic obse a ion.
Changes in o he indica o s acco ding o he scale o he ques ionnai e EORTC QLQ-
C30 we e luc ua ing in na u e and, ob iously, e lec he he e ogeneous s uc u e o he
in es iga ed con ingen on he adap a ion po en ial and he ans e o chemo he apy. Simila
dynamics was obse ed on he scales o he FACT-G ques ionnai e (Table 1, 2).
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Table 1 - Resul s o he e alua ion o QL by he ques ionnai e EORTC QLQ-C30 (M m)
Subscales
G oup I (n=50)
G oup II (n=100)
G oup III (n=100)
G oup IV (n=100)
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
PF
72,23,2
77,14,3
84,83,6
71,92,5
79,32,4
85,52,8
71,42,9
85,82,3
85,41,7
72,52,8
87,93,1
86,71,4
RF
67,43,4
75,23,8
76,33,5
68,32,2
80,12,9
81,52,6
66,73,3
85,42,2
85,82,9
65,92,9
86,33,2
85,93,3
CF
80,13,2
87,03,2
87,23,2
82,22,4
85,52,5
85,33,3
79,82,8
86,32,5
85,91,9
80,63,7
85,82,9
84,62,4
EF
32,73,2
63,92,9
62,63,2
33,92,6
66,32,3
70,42,4
34,12,7
70,82,2
78,51,4
31,51,8
71,82,4
78,82,2
SF
77,73,2
81,72,5
82,23,2
76,22,4
81,42,4
80,82,6
78,22,4
82,52,4
82,81,6
75,32,2
81,73,2
82,23,2
FA
29,33,2
33,33,2
40,23,2
28,72,2
34,13,4
39,91,2
30,12,5
41,42,4
42,82,2
29,92,3
42,22,2
43,31,2
NV
2,10,3
4,30,4
5,10,4
2,10,2
6,40,3
7,00,2
2,40,2
6,30,2
7,50,2
1,90,2
6,60,2
7,00,1
PA
27,32,4
34,23,2
38,83,2
27,52,2
33,32,3
37,72,1
25,61,5
36,31,2
39,61,8
25,91,2
35,51,4
38,11,4
SL
18,92,8
22,23,2
23,23,2
18,52,4
21,72,6
21,52,2
16,71,7
21,11,1
22,71,2
17,12,4
20,61,3
21,91,1
AR
14,02,2
19,32,8
20,83,2
14,42,4
18,82,4
19,92,4
14,62,3
18,51,6
18,91,2
13,82,6
19,72,4
21,21,6
CO
18,11,2
9,33,2
7,11,2
17,71,6
10,51,4
9,91,6
16,91,4
10,41,2
6,11,2
17,91,6
10,21,2
9,81,4
DI
4,20,3
2,10,3
1,90,3
4,30,3
1,90,2
1,80,2
4,00,2
2,00,2
1,90,2
3,90,3
1,90,1
1,90,2
FI
39,03,4
40,82,9
39,52,6
38,32,8
40,22,2
39,51,8
39,02,2
40,81,7
39,91,9
37,72,1
40,91,7
36,83,3
8
Table 2 - Resul s o he e alua ion o QL on he FACT-G ques ionnai e
Subscales
G oup I (n=50)
G oup II (n=100)
G oup III (n=100)
G oup IV (n=100)
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
Be o e
ea men
6 mon hs
a e
ea men
12 mon hs
a e
ea men
PWB
17,81,1
18,61,2
17,91,2
17,50,9
18,30,8
17,50,9
16,90,8
18,80,9
19,20,8
17,30,9
19,30,9
19,50,9
EWB
19,61,3
19,81,4
19,91,2
18,60,9
20,30,9
18,60,9
19,30,9
20,90,9
20,70,8
18,90,8
21,10,9
20,90,8
FWB
19,41,4
20,31,6
19,31,6
18,80,8
20,50,9
18,80,8
19,01,1
20,50,8
21,10,9
19,50,9
20,70,9
20,50,9
SWB
14,81,2
14,91,2
15,01,2
15,31,1
16,60,9
16,71,1
15,10,9
16,90,9
16,80,9
15,00,8
17,20,9
17,00,8
To al
71,51,4
73,61,3
72,21,2
70,20,9
75,70,8
71,60,9
70,30,9
77,10,9
77,80,9
70,80,8
78,30,8
77,90,8
No e: * - he di e ences wi h he baseline a e eliable (p<0.05)
9
Wi h undi e en ia ed use o chemo he apeu ic agen s wi hou me abolic suppo , he g ow h
o EWB subscale was om 19.61.3 o 19.91.4 poin s in he i s g oup and om 18.60.9 o 19.3
0.9 poin s - in he second g oup, whe eas in he III g oup he same indica o one yea a e
ea men was 20.70.8 poin s, and in he IV g oup - 20.90.8 poin s. In he case o di e en ia ed
use o chemo he apeu ic agen s wi h me abolic suppo , he o al sco e acco ding o he FACT-G
ques ionnai e was 77.8 0.9 poin s in g oup III, and 77.9 0.8 poin s in g oup IV, which
signi ican ly exceeds he ecei ed in g oups I and II - 72.21,2 and 71,60,9 poin s. In gene al, he
analysis o he dynamics o indica o s o LI on di e en scales indica es ha he di e en ia ed
app oach o he appoin men o chemo he apy o pa ien s wi h RI III-IV s age allows o imp o e
physical and emo ional unc ioning, educes he se e i y o side e ec s, while he pe iod o
p ese a ion o posi i e clinical e ec on QL is kep o a leas 12 mon hs.
Conclusions
1. Applica ion o he di e en ia ed app oach in he ea men o pa ien s wi h OC
signi ican ly imp o ed he indica o s on he scales o physical (PF), ole (RF) and emo ional
unc ioning (EF).
2. A e ea men , he in ensi y o nausea (NV) and gene al weakness (FA) dec eased
in pa ien s o g oups III and IV.
3. The desc ibed di e ences we e e ained o 12 mon hs a e he comple ion o he
cou se o ea men .
4. P ospec s o u he esea ch a e ela ed o he s udy o he dynamics o li e quali y
o pa ien s wi h OC a he subsequen s ages o ca amnes ic obse a ion.
Re e ences
1. Epidemiology Wo king G oup S ee ing Commi ee, O a ian Cance Associa ion
Conso ium Membe s o he EWG SC, in alphabe ical o de :, Dohe y JA, Jensen A, Kelemen LE,
Pea ce CL, Poole E, Schildk au JM, Te y KL, Two oge SS, Webb PM, Wen zensen N. Cu en
Gaps in O a ian Cance Epidemiology: The Need o New Popula ion-Based Resea ch. J Na l
Cance Ins . 2023 Oc 1; 109(10).
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ce ical cance sc eening. Odesa Medical Jou nal, 2022, 2022(1-2), pp. 93–96. DOI
10.54229/2226-2008-2022-1-2-16.
3. Bonda O, Rybin A, Pa sko A. The quali y o li e o o a ian cance pa ien s as an
indica ion o e ec i eness o pla inum-based adju an chemo he apy. Geo gian medical news 2021;
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