Kemps Shirley, Soleyman Mostafa, Huls Harmen, Labots Mariette, Crul Mirjam
Clinical Pharmacology and Pharmacy, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands.
Department of Medical Oncology, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands.
Eur J Hosp Pharm. 2024 Feb 22;31(2):111-116. doi: 10.1136/ejhpharm-2021-003215.
Most cytostatics used in cancer treatment are dosed on body surface area (BSA). To administer an appropriate dose it is therefore necessary to know the patient's correct body weight. However, evidence is lacking on how often, after initiation of treatment, body weight should be measured to recalculate BSA. We aimed to assess the relevance of weight measurements during chemotherapy treatment.
Over a 2 year period we analysed BSA changes in adult patients undergoing chemotherapy treatment. The frequency of and median time to ≥10% BSA change was determined. We assumed a 10% BSA change required dose adjustment and was therefore clinically relevant.
Using a database query, data from 2276 patients were used for descriptive statistics, life table analyses and generalised estimating equations. The frequency of ≥10% BSA change occurred in a maximum of 7.6% of the patients, depending on the tumour type. Descriptive statistics in the indications with more than 100 patients showed that BSA changes of ≥10% occurred after 84 days. The groups with the earliest BSA changes were patients with acute leukaemia, lymphoma and pancreatic cancer.
Our observations from real-world data indicate it is safe to omit the current requirement for monthly weight measurements. We advise that during chemotherapy, measuring the body weight in patients who have acute leukaemia, lymphoma or pancreatic cancer or who are under 20 years of age, should be performed at least every 3 months. For other patients, extending this period to a 6-monthly weight measurement should be considered.
大多数用于癌症治疗的细胞毒性药物是根据体表面积（BSA）给药的。因此，为了给予适当的剂量，有必要知道患者的正确体重。然而，关于治疗开始后应多久测量一次体重以重新计算体表面积，目前尚无证据。我们旨在评估化疗期间体重测量的相关性。
在2年的时间里，我们分析了接受化疗的成年患者的体表面积变化。确定了体表面积变化≥10%的频率和中位时间。我们假设体表面积变化10%需要调整剂量，因此具有临床相关性。
通过数据库查询，将2276例患者的数据用于描述性统计、生命表分析和广义估计方程。根据肿瘤类型，体表面积变化≥10%的频率最高为7.6%。对超过100例患者的适应症进行描述性统计表明，体表面积变化≥10%在84天后出现。体表面积变化最早的组是急性白血病、淋巴瘤和胰腺癌患者。
我们从真实世界数据中的观察结果表明，省略目前每月测量体重的要求是安全的。我们建议，在化疗期间，对于患有急性白血病、淋巴瘤或胰腺癌的患者或20岁以下的患者，应至少每3个月测量一次体重。对于其他患者，应考虑将测量周期延长至每6个月一次。
