(2012). An example of this is sepsis in patients undergoing chemotherapy.

A cautionary tale: dosing chemotherapy in infants with retinoblastoma. Excess fat often causes a reduction in daily creatinine urine excretion per kg of body weight, and can sometimes overestimate CrCl. Limited studies have been done in the obese population with regards to estimates of CrCl using the Cockcroft-Gault equation. 1989;7:1748-1756.

That system was started over 50 years ago. On the basis primarily of neurotoxicity concerns, vincristine is capped at a maximum dose of 2 mg when used as part of the CHOP [cyclophosphamide, doxorubicin, vincristine, prednisolone and CVP (cyclophosphamide, vincristine, prednisone)] regimens.In the majority of circumstances dose calculations for carboplatin are based solely on renal function. Journal of Oncology Practice / American Society of Clinical OncologyFreireich, E. J., Gehan, E. A., Rall, D. P., Schmidt, L. H., & Skipper, H. E. (1966).

Dosing according to the actual body weight of the patient may achieve better outcomes with documented safe toxicity profiles.Consensus guidelines are available to inform dosing of cytotoxic chemotherapy used in conditioning regimens for autologous or allogeneic transplant in the setting of obese overweight patients.Fixed dose or flat dose prescribing does not take into account body size or organ function and is rarely used for cytotoxic chemotherapy. (2007). Doctors and scientists looked for a better way – alternatives that accounted for factors affecting drug exposure and clearance such as liver and kidney function (Beumer, Chu, & Salamone, 2012).Measures related to body size such as body surface area, height and weight are used to calculate the required doses, as they theoretically are a way to tailor doses according to body size and ability to clear the drug.Most drugs doctors prescribe are administered as in fixed doses. Calculated doses may require ‘rounding’ to enable delivery of a measurable dose for both parenteral and oral doses and will depend on local practice (e.g. All dose reductions that deviate from a standard evidence-based protocol should be clearly documented. Experiments with small animals identify the lethal dose, which is probably going to be about the same (scaling for body size) as the lethal dose for humans. � ��� x�3R��2�35W(�*T0P�R0T(�Y@���@QC= P A�J��� �1Tp�W� These are real scientific discoveries about the nature of the human body, which can … So, it was thought, the capacity of the body to withstand up to the negative effects of harsh chemotherapy drugs would scale with BSA. Direct measurements of GFR using radiolabelled EDTA must be considered for patients receiving adjuvant or higher dose carboplatin. This Carboplatin AUC calculator will then retrieve you some useful indicators about the kidney function, the GFR value, the ideal weight and the total dosage required in the used case. The use of body surface area as a criterion of drug dosage in cancer chemotherapy.

Most available systems have configurable calculators embedded, thereby allowing each institution to select which formula they wish to use.

Body surface area correlates with the capacity of the kidneys and liver, which are the organs that detoxify and eliminate poisons. The checking of the patient's renal function during therapy with carboplatin to recalculate the carboplatin doses will depend on local policy, treatment intent and the extent of renal function change. Limited studies have been performed in the obese cancer population with regards to estimates of CrCl using the Cockcroft-Gault equation. A. Body surface area-dosing does not account for the complex processes of cytotoxic drug elimination. Flat-Fixed Dosing Versus Body Surface Area Based Dosing of Anticancer Drugs: There Is a Difference. 4 0 obj This practice increases the risk of under-dosing; under-dosing is almost as big a concern as the risk of toxicity in overdosing (Field et al., 2008). Free oncology and general medical calculators for drug dosage, neutrophil count, BSA, GFR and many more. (2012).