Advanced Body Measurement Techniques Can Complement Current Methods of Cytotoxic Chemotherapy Dose Prescription

Author:

Thelwell Michael1ORCID,Masters Neil2ORCID,Appleyard Robert3,Bullas Alice May1ORCID

Affiliation:

1. Sports Engineering Research Group, Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield S9 3TY, UK

2. Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2SJ, UK

3. Centre for Applied Health & Social Care Research, Sheffield Hallam University, Sheffield S1 1WB, UK

Abstract

Within chemotherapy, estimates of a patient’s body surface area (BSA) are used to calculate drug dosages. However, the use of BSA for calculating chemotherapy dosage has been heavily criticised in previous literature, with potentially significant implications for the effectiveness and toxicity of treatment. BSA has been found to be a poor indicator of optimal drug exposure that does not account for the complex processes of cytotoxic drug distribution and elimination. In addition, differences in BSA estimates between existing formulae have been shown to be so large that they can affect patients’ mortality, particularly in patients with atypical body types. This uncertainty associated with BSA prediction may decrease the confidence of practitioners when determining chemotherapy dosages, particularly with regards to the risk of excess toxicity from over-dosing, or a reduced anti-cancer effect due to under-dosing. The use of national dose-banding in the UK may in some cases account for possible inaccuracies, but the threshold of variance in this case is small (+/−6%). Advanced body measurement techniques, utilising digital tools such as three-dimensional (3D) surface imaging, capture accurate external dimensions and detailed shape characteristics of the human body. Measures of body shape describe morphological variations that cannot be identified by traditional anthropometric techniques and improve the prediction of total body fat and distribution. It is our view that the use of advanced body measurement techniques can provide practitioners with tools for prescribing chemotherapy dosages that are valid for individuals, regardless of their body type.

Publisher

MDPI AG

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