Body-Surface Area–Based Chemotherapy Dosing: Appropriate in the 21st Century?

2012/09/11 by Jan H. Beumer, Edward Chu, Salvatore J. Salamone · 56 citations
Medicine · Physics and Astronomy · #Advanced Radiotherapy Techniques #Body surface area #Cancer Treatment and Pharmacology #Chemotherapy #Dosing #Glioma Diagnosis and Treatment #Intensive care medicine #Internal medicine #Medicine #Oncology

paper · pdf · doi:10.1200/jco.2012.44.2863

published in Journal of Clinical Oncology 30(31), 3896-3897 (Lippincott Williams & Wilkins)

openalex publication_date 2012/09/11 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/15

Abstract

The article by Griggs et al 1 gave guidelines for appropriate dosing for obese adult patients that use body-surface area (BSA) to determine dose. The oncology community is in general agreement that patients should be given an optimal dose that results in clinical benefit and that a reduction in "dose-intensity may compromise disease-free survival (DFS) and overall survival (OS) in the curative setting." 1( p1553) Historically, dosing of obese patients has been problematic, and to date, there has been no standardized approach. Although Griggs et al propose the use of BSA to determine dose, it seems that this recommendation lacks true level-one evidence. The new recommendation aims to achieve the same maximum doseintensity in the obese, arguing for full weight-based calculation of BSA to determine doses as opposed to using a reduced weight metric or dose capping. However, there is growing evidence that there are significant limitations with respect to BSA-based dosing.

Citations

• Role of Body Surface Area in Dosing of Investigational Anticancer Agents in Adults, 1991-2001
• Individual Fluorouracil Dose Adjustment Based on Pharmacokinetic Follow-Up Compared With Conventional Dosage: Results of a Multicenter Randomized Trial of Patients With Metastatic Colorectal Cancer
• Individual Fluorouracil Dose Adjustment in FOLFOX Based on Pharmacokinetic Follow-Up Compared With Conventional Body-Area-Surface Dosing: A Phase II, Proof-of-Concept Study
• Dosing strategies for anticancer drugs: the good, the bad and body-surface area

Cited by

• Chemotherapy [wikipedia]

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