Medical Oncology Department, Lucien Neuwirth Cancer Center, 42270, Saint Priest en Jarez, France.
Pharmacy Department, Lucien Neuwirth Cancer Center, 42270, Saint-Priest en Jarez, France.
Sci Rep. 2021 Jan 28;11(1):2431. doi: 10.1038/s41598-021-81792-6.
Capping body surface area (BSA) at 2 m is a routine clinical practice. It aims at reducing toxicities in over 2 m BSA patients. 455,502 computerized chemotherapy prescriptions made between 2011 and 2017 were taken from BPC software. Chemotherapy computerized order entry is created by a senior physician prescribers before patient consultation. Only prescriptions with dose calculation involving BSA were selected. 51,179 chemotherapy prescriptions were analyzed; corresponding to 7206 patients who received intravenous chemotherapy. The number of chemotherapy prescriptions in over 2 m BSA patients was nearly the same in the hematology as in the oncology departments. But, 79.1% of prescriptions were capped at 2 m in the oncology department contrary to 21.9% in the hematology department. Practices analysis showed more dose limitation in palliative situations in both departments. Unexpectedly, 6.53% of capped prescriptions were performed in patients with normal BMI. The patients who received capped doses of chemotherapy had neither fewer dose reductions due to toxicity nor deterioration of their general condition. Capping did not induce fewer dose reductions in patients with BSA greater than 2 m. Prospective studies in this population are needed to standardize chemotherapy administration in population with BSA > 2 m.
体表总面积（BSA）封顶至 2 平方米是一种常规的临床实践。其目的是降低 BSA 超过 2 平方米患者的毒性。从 BPC 软件中提取了 2011 年至 2017 年间的 455502 份计算机化疗处方。化疗计算机医嘱录入是由资深医师在患者咨询前创建的。仅选择涉及 BSA 剂量计算的处方。分析了 51179 份化疗处方；对应于接受静脉化疗的 7206 名患者。BSA 超过 2 平方米的患者的化疗处方数量在血液科和肿瘤科几乎相同。但是，肿瘤科有 79.1%的处方被封顶至 2 平方米，而血液科仅有 21.9%。实践分析显示，两个科室的姑息治疗情况下，剂量限制更多。出乎意料的是，6.53%的封顶处方是在 BMI 正常的患者中进行的。接受封顶剂量化疗的患者，由于毒性而减少剂量或一般状况恶化的情况并不多。BSA 大于 2 平方米的患者，封顶并未导致减少剂量。需要对该人群进行前瞻性研究，以标准化 BSA>2 m 人群的化疗管理。
