Danesi Valentina, Andalò Alice, Cavallucci Martina, Balzi William, Gentili Nicola, Altini Mattia, Maltoni Roberta, Massa Ilaria, Vallicelli Giorgia, Montella Maria Teresa, Masini Carla, Roncadori Andrea
Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumouri (IRST) "Dino Amadori", Meldola, Italy.
Data Unit, Healthcare Administration, IRCCS Istituto Scientifico Romagnolo per lo Studio Tumouri (IRST) "Dino Amadori", Meldola, Italy.
PLoS One. 2024 Dec 17;19(12):e0314452. doi: 10.1371/journal.pone.0314452. eCollection 2024.
Although body weight (BW) and body surface area (BSA) are utilized to establish the appropriate dosage of anticancer drugs, their distribution in cancer patients is poorly studied, making it challenging to predict the amount of drug use and related costs of BW or BAS-dosed regimens. This study investigates the distribution of BW and BSA in adults with selected cancers who initiated systemic anticancer treatment in the eastern Emilia-Romagna region hospitals between 2011 and 2021. BW and BSA were collected at the first cycle of each new treatment line, with multiple measurements for patients receiving various treatments or treating for other primary malignancies. Results were grouped by sex, tumor site and treatment setting, and the normal distribution hypothesis was tested for each group. Both linear regression model and quantile regression at the 50th, 25th and 75th percentiles were run to explore the factors influencing BSA. The analysis included 20,634 treatment lines and the corresponding BW and BSA measures from a sample of 13,036 patients. The average BW was 68.05kg (64.20kg for females and 75.07kg for males) and the average BSA was 1.76m2 (1.66m2 for females and 1.87m2 for males). In women, the highest BW was in breast and colon groups, while in men, it was associated with prostate and rectum cancers. The model indicated significant association between BSA, age, sex and tumor localization. Notably, stomach and lung cancers were linked to lower BSA for both sexes (for females -0.081 and -0.041m2 respectively compared to those with breast cancer). Advanced settings were related to lower BSA than neoadjuvant treatment, especially for stomach cancer patients, who experienced a weight loss of 3 to 6kg as therapy progressed. The regression models for predicting BSA can assist regulatory bodies in determining reimbursement for new chemotherapy drugs and help hospitals forecast drug utilization and expenditure more accurately.
尽管体重(BW)和体表面积(BSA)被用于确定抗癌药物的合适剂量,但它们在癌症患者中的分布情况研究较少,这使得预测BW或BSA给药方案的用药量及相关成本具有挑战性。本研究调查了2011年至2021年间在艾米利亚 - 罗马涅大区东部医院开始接受全身抗癌治疗的特定癌症成年患者的BW和BSA分布情况。在每个新治疗线的第一个周期收集BW和BSA,对于接受多种治疗或治疗其他原发性恶性肿瘤的患者进行多次测量。结果按性别、肿瘤部位和治疗设置分组,并对每组进行正态分布假设检验。运行线性回归模型以及第50、25和75百分位数的分位数回归,以探索影响BSA的因素。分析包括来自13,036名患者样本的20,634个治疗线以及相应的BW和BSA测量值。平均BW为68.05kg(女性为64.20kg,男性为75.07kg),平均BSA为1.76m²(女性为1.66m²,男性为1.87m²)。在女性中,最高BW出现在乳腺癌和结肠癌组,而在男性中,它与前列腺癌和直肠癌相关。该模型表明BSA、年龄、性别和肿瘤定位之间存在显著关联。值得注意的是,胃癌和肺癌在两性中均与较低的BSA相关(女性分别为-0.081和-0.041m²,与乳腺癌患者相比)。晚期治疗设置与比新辅助治疗更低的BSA相关,尤其是对于胃癌患者,随着治疗进展体重减轻3至6kg。预测BSA的回归模型可以帮助监管机构确定新化疗药物的报销额度,并帮助医院更准确地预测药物使用和支出。