Body surface area capping may not improve cytotoxic drugs tolerance

Area of Science:

• Oncology
• Pharmacology
• Clinical Practice

Background:

• Capping body surface area (BSA) at 2 m² is a common practice to mitigate chemotherapy toxicity in patients with larger BSA.
• The efficacy and necessity of this practice, particularly in diverse clinical settings, require further investigation.

Purpose of the Study:

• To analyze the frequency and impact of body surface area (BSA) capping in chemotherapy prescriptions.
• To evaluate whether BSA capping influences dose reductions due to toxicity or patient outcomes.

Main Methods:

• Retrospective analysis of 51,179 computerized chemotherapy prescriptions for 7206 patients between 2011 and 2017.
• Comparison of BSA capping practices between oncology and hematology departments.
• Assessment of dose reductions and patient condition in relation to BSA capping.

Main Results:

• BSA capping was more prevalent in oncology (79.1%) than hematology (21.9%), especially in palliative cases.
• 6.53% of capped prescriptions were for patients with normal BMI.
• Capped chemotherapy doses did not lead to fewer toxicity-related dose reductions or improved patient condition.

Conclusions:

• Current BSA capping practices at 2 m² may not effectively reduce chemotherapy toxicity or dose reductions in patients with BSA > 2 m².
• Variations in capping practices exist between oncology and hematology.
• Prospective studies are essential to establish standardized chemotherapy administration guidelines for patients with BSA > 2 m².