Emergency Department, Blount Memorial Hospital, Maryville, TN 37804, USA.
J Am Pharm Assoc (2003). 2013 Jul-Aug;53(4):420-2. doi: 10.1331/JAPhA.2013.12053.
To identify variations in carboplatin dose calculations at oncology institutions and practices in the southeastern United States.
500 surveys were mailed to oncology practices in the southeastern United States to assess variations in carboplatin doses. The survey sought to determine assumptions that are made regarding carboplatin calculations and if different carboplatin doses result when participants are given the same data and patient characteristics.
The survey had a response rate of 12% (n = 56 of 467). The majority of responses used actual serum creatinine and actual body weight. The Cockcroft-Gault creatinine clearance formula was used most commonly. The doses calculated in the case example of an AUC (area under the curve) 6 dose of carboplatin ranged from 110 to 1,811 mg (mean 987 mg, median 963 mg). We determined a correct dose of 721 mg for the case example.
The majority of responses to the case example indicated overdosing of carboplatin. Participants provided inconsistent doses, and their interpretation of the variables in the equations varied. More research is needed, and efforts should be made to have a universal modified Calvert formula with standardized assumptions to achieve consistent dosing across practices.
确定美国东南部肿瘤医疗机构和实践中卡铂剂量计算的差异。
向美国东南部的肿瘤实践机构邮寄了 500 份调查，以评估卡铂剂量的差异。该调查旨在确定在进行卡铂计算时所做的假设，以及当参与者获得相同的数据和患者特征时，是否会得出不同的卡铂剂量。
该调查的回复率为 12%（467 份中的 56 份）。大多数回复都使用了实际的血清肌酐和实际体重。最常用的是 Cockcroft-Gault 肌酐清除公式。在 AUC（曲线下面积）为 6 的卡铂剂量的病例示例中计算的剂量范围为 110 至 1811mg（平均值为 987mg，中位数为 963mg）。我们确定了该病例的正确剂量为 721mg。
大多数对病例示例的回复表明卡铂剂量过高。参与者提供了不一致的剂量，他们对公式中的变量的解释也存在差异。需要进一步研究，并应努力制定具有标准化假设的通用改良 Calvert 公式，以实现实践之间的一致剂量。
