Portugal Rodrigo Doyle
Avenida Brigadeiro Trompowsky S/N, Hospital Universitario, Servico de Hematologia 4(0) andar, 21941-590 Rio de Janeiro, Brazil.
Med Hypotheses. 2005;65(4):748-51. doi: 10.1016/j.mehy.2005.04.023.
It is generally accepted that anti-neoplastic chemotherapy dose should be calculated according to body surface area (BSA). This approach does not account for the presence of obesity. Hence, patients with the same BSA will receive the same chemotherapy dose, regardless the presence of obesity. Since this may cause of toxicity in some obese patients, practice of limit BSA is usual. Currently, the body mass index (BMI) is largely used as a marker of obesity and both BSA and BMI include only height (h) and weight(w) in their formula. We put forward the hypothesis that the BMI should also be taken in account for calculation of chemotherapy dose for obese patients (BMI > 30 kg/m2). In this article, we present a correction to BSA (CBSA) based on the BMI to be tested in obese patients. Our main result is given by the equationCBSA=K(alpha1h(alpha2+2kappa)w(alpha3-kappa)),whereand kappa, alpha1, alpha2, alpha3 are constants. We show examples of how to calculate the CBSA. This simple strategy may limit drug exposition and maintain greater efficacy than a fixed limitation of BSA.
一般认为，抗肿瘤化疗剂量应根据体表面积（BSA）来计算。这种方法没有考虑肥胖因素。因此，具有相同体表面积的患者，无论是否肥胖，都会接受相同的化疗剂量。由于这可能会在一些肥胖患者中导致毒性反应，限制体表面积的做法很常见。目前，体重指数（BMI）在很大程度上被用作肥胖的指标，并且体表面积和体重指数在其公式中都仅包含身高（h）和体重（w）。我们提出这样一个假设，即对于肥胖患者（BMI>30kg/m²），在计算化疗剂量时也应考虑体重指数。在本文中，我们提出了一种基于体重指数的体表面积校正值（CBSA），用于在肥胖患者中进行测试。我们的主要结果由公式CBSA = K(alpha1h(alpha2 + 2kappa)w(alpha3 - kappa))给出，其中kappa、alpha1、alpha2、alpha3为常数。我们展示了如何计算CBSA的示例。这种简单的策略可能会限制药物暴露，并比固定限制体表面积保持更高的疗效。
