Body-surface-area dosing
Chemotherapy doses are usually written per square metre of body surface, a convention from 1958 that scales drug clearance between species and people; it is imprecise, and for many newer drugs flat or weight-based doses have replaced it.
Overview
Donald Pinkel proposed in 1958 that anticancer drug doses be scaled to body surface area, because clearance across species tracked surface area better than weight, and the convention spread to adults. Surface area is estimated from height and weight by the Du Bois or Mosteller formulas. Pharmacokinetic studies later showed that surface area explains little of the variation in clearance between adults, that dose capping in obese patients underdoses them, and that many antibodies and oral targeted drugs are as well given at flat doses. Body-surface-area dosing persists for classic cytotoxics, while carboplatin is dosed by kidney function and children's doses use weight or surface area by age.
How it works
Dose = dose per square metre × body surface area, with surface area from height and weight; assumes clearance scales with surface area.
- Universal convention for cytotoxics
- Scales between children and adults
- Simple to calculate
- Explains little inter-adult variability
- Underdosing of obese patients when capped
- Unnecessary for many modern drugs
Latest papers
topQuery for this technology: (TITLE:"Body-surface-area dosing" OR ABSTRACT:"Body-surface-area dosing") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Body-surface-area dosing, not a curated reading list.
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