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I Need Feedback About Chemotherapy Protocols


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For background, Snickers saw a board-certified oncologist for her intiital consult and first chemo treatment. He set up a five-dose (I think I may have written four earlier, but I just checked his consult notes) plan for Carboplatin. Before her second treatment, he left the group and now a different doctor, who is younger (the other is in his early 40s I think) and just taking his oncology boards this month, proposed alternative doxy/carbo for a total of six.

 

I'm a little puzzled,why the new vet changed the protocol established by an experienced oncologist.

 

I did go ahead and do the doxy for Snickers on Tuesday, with the assurance from the vet that we could revert to Carbo only.

 

I e-mailed OSU, and they say they haven't experienced much difference between results of single-agent Carbo and doxy, and there isn't much in the way of statistics to support the double-agent chemo. OSU administers only doxy as a single-agent too.

 

Any opinions, experiences, even statistics would be helpful. I'm leaning toward the Carbo only because it has fewer side effects, especially since doxy can have cardiotoxicity.

 

 

 

 

Aero: http://www.greyhound-data.com/d?d=kees+uncatchable; our bridge angel (1/04/02-8/2/07) Snickers; our bridge angel (1/04/02-2/29/08) Cricket; Kanga Roo: oops girl 5/26/07; Doctor Thunder http://www.greyhound-data.com/d?z=P_31Oj&a...&birthland=
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Dylan had three alternating treatments each of Adriamycin and the Carboplatin.

Wendy and The Whole Wherd. American by birth, Southern by choice.
"Do not meddle in the affairs of dragons, for you are crunchy and taste good with ketchup!"
****OxyFresh Vendor ID is 180672239.****

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Guest LynnM

Ask the vet about the differences between the two. Very few here are going to have any experience with cytotoxic drugs or protocols. Best to get the info straight from the source.

 

Lynn

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We had 4 treatments of carboplatin for JC. The oncologist who set up the protocol said we could do either that or the adriamycin/carboplatin combo. We opted for the single agent since it would have less potential side effects and it worked out fine. JC never got sick from the treatment and he lived almost another 3 years, so for him the outcome was excellent.

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Guest MorganKonaAlex

Morgan had 4 rounds of Carbo and was still doing great when Alex was diagnosed. I questioned the new Vet's recommendation to do alternating carbo/doxy with Alex. This is the study she referenced.

 

Alternating Carboplatin and Doxorubicin as Adjunctive Chemotherapy to Amputation or Limb-Sparing Surgery in the Treatment of Appendicular Osteosarcoma in Dogs

 

Michael S. Kent, Adam Strom, Cheryl A. London, and Bernard Seguin

 

Thirty-two dogs with appendicular osteosarcoma treated by amputation or limb sparing had adjuvant chemotherapy of alternating doses of carboplatin (300 mg/m2 IV) and doxorubicin (30 mg/m2 IV) every 21 days for a total of 3 cycles. Efficacy, toxicity, and previously identified prognostic factors for osteosarcoma were evaluated. The median progression free survival was 227 days (range 180–274), and the median overall survival was 320 days (range 153–487). The 1-year survival rate was 48%, and the 2-year survival rate was 18%. Age, sex, surgical procedure, and alkaline phosphatase activity above the reference ranges were not prognostic for survival. There was minimal toxicity associated with the chemotherapy. This protocol could be useful for the adjuvant treatment of appendicular osteosarcoma of dogs.

 

 

 

This web site contains survival stats with the various protocols: link

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Guest LynnM
True but she is asking who to believe. That is why I said I'd go with experience, not the new vet.

 

When all else fails, go with your gut feeling.

 

I'm the first to admit that I'm not up on chemo protocols nor am I a vet. If I had two different protocols recommended by two very qualified vets (both boarded), I'd be very eager to find out what the differences are between the two. Just because something is the "newest, greatest thing" doesn't always make it better, but conversely, a particular procedure or protocol almost always has room for improvement. The vet himself is the best person to ask. There may be a very good reason for his recommendation. The only way to know is to ask.

 

Lynn

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True but she is asking who to believe. That is why I said I'd go with experience, not the new vet.

 

When all else fails, go with your gut feeling.

 

I'm the first to admit that I'm not up on chemo protocols nor am I a vet. If I had two different protocols recommended by two very qualified vets (both boarded), I'd be very eager to find out what the differences are between the two. Just because something is the "newest, greatest thing" doesn't always make it better, but conversely, a particular procedure or protocol almost always has room for improvement. The vet himself is the best person to ask. There may be a very good reason for his recommendation. The only way to know is to ask.

 

Lynn

 

That's the trouble...I did ask. The first oncologist, who is boarded and experienced, said that there wasn't much evidence that the double-agent chemo gave any better results. I was happy with the Carboplatin as a single agent and trusted his opinion.

 

There is a slight difference in experience levels -- the first vet has more experience and is a diplomate, board certified. The second vet is scheduled for his boards this month although has limited his work to oncology.

 

It sounds like there are different schools of thought among oncologists and no one is really sure what the definitive answer is.

 

Because of this ambiguity, I wanted anecdotal feedback from other grey owners who have chosen particular treatment courses and what their dogs experienced for side effects, etc..

 

My gut feeling is to revert to the Carboplatin only -- but I welcome any feedback or opinions.

Aero: http://www.greyhound-data.com/d?d=kees+uncatchable; our bridge angel (1/04/02-8/2/07) Snickers; our bridge angel (1/04/02-2/29/08) Cricket; Kanga Roo: oops girl 5/26/07; Doctor Thunder http://www.greyhound-data.com/d?z=P_31Oj&a...&birthland=
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Guest JohnnyBell

OSU put Sophie on Doxorubicin x 5 doses as a single agent.They say this is what they use for osteo so I'm sure is a good agent.I really don't know about any of the other ones.I would wonder myself why the new vet is changing it.Good Luck!!!!

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