Appropriate chemotherapy dosing for obese adult patients with cancer: American Society of Clinical Oncology clinical practice guideline
| Autor: | Vicki A. Morrison, Carolyn D. Runowicz, James J. Dignam, Gary L. Rosner, T. May Pini, Pamela B. Mangu, Edward P. Balaban, Alex Sparreboom, Michelle Shayne, Holly Anderson, William Hryniuk, Lara Sucheston, Jennifer J. Griggs, Gary H. Lyman |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Body Surface Area medicine.medical_treatment Antineoplastic Agents Gynecologic oncology law.invention law Neoplasms medicine Humans Drug Dosage Calculations Dosing Obesity Practice Patterns Physicians' Intensive care medicine Gynecology Body surface area Chemotherapy Clinical pharmacology Evidence-Based Medicine business.industry Body Weight Cancer Evidence-based medicine Guideline medicine.disease Treatment Outcome Oncology Pharmacogenetics business |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 30(13) |
| ISSN: | 1527-7755 |
| Popis: | Purpose To provide recommendations for appropriate cytotoxic chemotherapy dosing for obese adult patients with cancer. Methods The American Society of Clinical Oncology convened a Panel of experts in medical and gynecologic oncology, clinical pharmacology, pharmacokinetics and pharmacogenetics, and biostatistics and a patient representative. MEDLINE searches identified studies published in English between 1996 and 2010, and a systematic review of the literature was conducted. A majority of studies involved breast, ovarian, colon, and lung cancers. This guideline does not address dosing for novel targeted agents. Results Practice pattern studies demonstrate that up to 40% of obese patients receive limited chemotherapy doses that are not based on actual body weight. Concerns about toxicity or overdosing in obese patients with cancer, based on the use of actual body weight, are unfounded. Recommendations The Panel recommends that full weight–based cytotoxic chemotherapy doses be used to treat obese patients with cancer, particularly when the goal of treatment is cure. There is no evidence that short- or long-term toxicity is increased among obese patients receiving full weight–based doses. Most data indicate that myelosuppression is the same or less pronounced among the obese than the non-obese who are administered full weight–based doses. Clinicians should respond to all treatment-related toxicities in obese patients in the same ways they do for non-obese patients. The use of fixed-dose chemotherapy is rarely justified, but the Panel does recommend fixed dosing for a few select agents. The Panel recommends further research into the role of pharmacokinetics and pharmacogenetics to guide appropriate dosing of obese patients with cancer. |
| Databáze: | OpenAIRE |
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