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Title of Journal: Support Care Cancer

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Abbravation: Supportive Care in Cancer

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Springer-Verlag

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DOI

10.1016/0032-0633(75)90199-3

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1433-7339

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Implications of dose rounding of chemotherapy to t

Authors: Michael Joseph Dooley Sanjay Singh Michael Michael
Publish Date: 2004/02/18
Volume: 12, Issue: 9, Pages: 653-656
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Abstract

There are practical implications of preparing cytotoxic doses calculated to the exact milligram The objective here was to explore the magnitude of the effect of dose rounding to the nearest whole vial strength for some newly marketed expensive cytotoxic chemotherapy agentsBody surface areas BSA of 2838 adult patients presenting for chemotherapy at the Peter MacCallum Cancer Centre between May 1996 and December 2000 were calculated by using the DuBois and DuBois linear equation to two decimal places Each individual dose of docetaxel liposomal doxorubicin gemcitabine oxaliplatin and vinorelbine was calculated from the actual BSA based on the dose recommended in the approved drug product information This calculated dose was then rounded upwards to the full next vial if the calculated dose exceeded above 50 of the next appropriate vial strength and was rounded downwards to the full previous vial if the calculated dose did not exceed above 50 of the next appropriate vial strength Potential impacts on cost were calculated in Australian dollars for each drug for both the calculated and rounded dose on those instances where the difference was no greater than ±5The proportion of patients in whom the dose rounded to the nearest vial strength varied by not more than ±5 was 895 for docetaxel 604 for liposomal doxorubicin 994 for gemcitabine 34 for oxaliplatin and 563 for vinorelbine The implications of dose rounding in financial terms are significant and project savings of 4–142

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