Sharkey I, Boddy A V, Wallace H, Mycroft J, Hollis R, Picton S
Pharmacy Dept, Royal Victoria Infirmary, Newcastle, UK
Br J Cancer. 2001 Jul 6;85(1):23-8. doi: 10.1054/bjoc.2001.1859.
The majority of chemotherapy regimens and trials specify doses of cytotoxic drugs normalized to body surface area. Estimation of BSA in paediatric patients is particularly problematic, as conventional nomograms require accurate determination of both height and weight. The chemotherapy standards group of the UKCCSG (United Kingdom Children's Cancer Study Group) has evaluated a method for calculation of body surface area (BSA) estimation, based solely on patient weight. In comparison with BSA estimations using 2 commonly used methods, which require both weight and height measurements, deviation in the estimate of BSA was less than 10%. This method may be extended to the dosing of chemotherapeutic agents in infants of body weight less than 10 kg, with appropriate recommendations for dose modification. Until better correlates of drug clearance, such as GFR for carboplatin, are identified BSA is used to standardize doses for most chemotherapeutic agents. The formula presented here provides a more robust and reliable method of calculation of BSA from weight alone. Although this approach has been shown to be equivalent to other currently used methods, care should be taken extending this calculation of BSA to children less than 10 kg, to obese patients and to those with cachexia.
大多数化疗方案和试验都规定了根据体表面积标准化的细胞毒性药物剂量。在儿科患者中估算体表面积尤其困难，因为传统的列线图需要准确测定身高和体重。英国儿童癌症研究组（UKCCSG）的化疗标准小组评估了一种仅基于患者体重来计算体表面积（BSA）的方法。与使用另外两种常用方法（这两种方法都需要测量体重和身高）估算的体表面积相比，该方法估算的体表面积偏差小于10%。这种方法可扩展用于体重小于10 kg婴儿的化疗药物给药，并给出了适当的剂量调整建议。在确定更好的药物清除率相关指标（如卡铂的肾小球滤过率）之前，体表面积用于标准化大多数化疗药物的剂量。这里给出的公式提供了一种仅根据体重就能更稳健、更可靠地计算体表面积的方法。尽管这种方法已被证明与目前使用的其他方法等效，但将这种体表面积计算方法扩展应用于体重小于10 kg的儿童、肥胖患者以及恶病质患者时应谨慎。
