Evaluation of an alternate dosing strategy for cisplatin in patients with extreme body surface area values
Evaluation of an alternate dosing strategy for cisplatin in patients with extreme body surface area values
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DOI：
10.1200/jco.2005.03.0056
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发表时间：
2006-04-01
影响因子：
45.3
通讯作者：
Verweij, J
中科院分区：
文献类型：
--
作者：
Loos, WJ;de Jongh, FE;Verweij, J
目的大多数成人细胞毒性药物的剂量是根据体表面积 (BSA) 确定的，旨在减少患者间药物暴露的变异性。我们前瞻性地研究了基于 BSA 的顺铂剂量在 BSA 值极端的患者中的有效性。患者和方法患者被随机分配在第 1 疗程中接受固定剂量的顺铂，在第 2 疗程中接受 BSA 调整剂量，反之亦然。固定剂量基于男性和女性的平均 BSA，而极端剂量设定为超过平均 1 个标准差的 BSA 值。随后，我们回顾性分析了正常人群的数据。结果在 25 名可评估两个疗程的患者中，与 BSA 调整剂量后的暴露相比，使用固定剂量的顺铂导致 BSA 上限患者的未结合铂暴露减少 (P =.003)，而下限患者的暴露量更高 (P =.009)。尽管清除率与 BSA 相关（R-2 = 0.44；P
PurposeThe majority of cytotoxic drugs for adults are dosed based on body surface area (BSA), aiming to reduce interpatient variability in drug exposure. We prospectively studied the usefulness of BSA-based dosing of cisplatin in patients at extremes of BSA values.Patients and MethodsPatients were randomly assigned to receive a fixed dose of cisplatin in course 1, and a BSA-adjusted dose in course 2, or vice versa. The fixed dose was based on the average BSA for males and females, while extremes were set at BSA values exceeding the average 1 standard deviation. Subsequently, we retrospectively analyzed data from a normal population.ResultsIn 25 patients assessable for both courses, the use of a fixed dose of cisplatin resulted in reduced exposure to unbound platinum in patients at the upper extremes of BSA (P =.003) and higher exposures in patients at the lower extremes (P =.009), as compared with exposures following the BSA-adjusted dose. Although clearance was related to BSA (R-2 = 0.44; P