Wafa Bouleftour, Aurane Raphard, Fabien Tinquaut, Romain Rivoirard, Fabien Forges
Medical Oncology Department, CHU Saint Etienne, Saint Etienne, France.
Pharmacy Department, CHU Saint Etienne, Saint Etienne, France.
Sci Rep. 2025 Aug 4;15(1):28415. doi: 10.1038/s41598-025-14279-3.
Capping body surface area (BSA) at 2.0 m is a common clinical practice. This empirical practice is intended to mitigate toxicities. In this context, the objective of this study was to investigate in curative situation whether capping chemotherapy prescriptions at 2.0 m had an influence on the efficacy and tolerance of treatment in patients diagnosed with early-stage breast cancer. Data from patients with a body surface area (BSA) greater than 2.0 m² who received treatment for medium and high-risk early-stage breast cancer, either in (neo)adjuvant settings, from January 1, 2010, to December 31, 2018, were examined. Patients were divided into four categories based on the percentage of chemotherapy capping throughout the treatment duration: [90-100]: the reference group, representing fully capped chemotherapy with capping exceeding 90%; [50-90[: capped chemotherapy ranging from 50 to 90%; [10-50[: capped chemotherapy between 10% and 50%; and [0-10[: representing non-capped chemotherapy. A total of 130 patients were included in the analysis, with a median age at diagnosis of 57 years (Interquartile range (IQR): 48-63) and a mean BSA of 2.07 m². Chemotherapy was provided as an adjuvant treatment to 86.9% of the participants. Depending on the capping group, the hematological toxicities were almost similar in all groups whereas non-hematological toxicities were slightly higher in the capped group between [10-50[. Similarly, chemotherapy dose reduction was also higher in capped group between [10-50[in comparison with other groups. A significant difference was observed in non-hematological toxicities of grade ≥ 2 between the reference group [90-100] and the capping group [10-50[(OR 3.59; 95% CI [1.26-10.22], p = 0.017). Prospective studies are needed to support the practice of capping, particularly in curative situations.
将体表面积（BSA）上限设定为2.0平方米是一种常见的临床做法。这种经验性做法旨在减轻毒性。在此背景下，本研究的目的是调查在根治性情况下，将化疗处方的体表面积上限设定为2.0平方米是否会对早期乳腺癌患者的治疗疗效和耐受性产生影响。研究分析了2010年1月1日至2018年12月31日期间，在（新）辅助治疗中，接受中高危早期乳腺癌治疗且体表面积（BSA）大于2.0平方米的患者数据。根据整个治疗期间化疗上限的百分比，将患者分为四类：[90 - 100]：参照组，代表化疗完全上限且上限超过90%；[50 - 90]：化疗上限为50%至90%；[10 - 50]：化疗上限在10%至50%之间；[0 - 10]：代表无上限化疗。共有130名患者纳入分析，诊断时的中位年龄为57岁（四分位间距（IQR）：48 - 63），平均体表面积为2.07平方米。86.9%的参与者接受了辅助化疗。根据上限分组，所有组的血液学毒性几乎相似，而在[10 - 50]的上限组中，非血液学毒性略高。同样，与其他组相比，[10 - 50]的上限组化疗剂量减少也更高。在参照组[90 - 100]和上限组[10 - 50]之间，观察到≥2级非血液学毒性存在显著差异（OR 3.59；95% CI [1.26 - 10.22]，p = 0.017）。需要进行前瞻性研究来支持设定上限的做法，特别是在根治性情况下。
