Body surface area estimation in children using weight alone: application in paediatric oncology

The majority of chemotherapy regimens and trials specify doses of cytotoxic drugs normalized to body surface area. Estimation of BSA in paediatric pat ients is particularly problematic, as conventional nomograms require accura te determination of both height and weight. The chemotherapy standards grou p of the UKCCSG (United Kingdom Children's Cancer Study Group) has evaluate d a method for calculation of body surface area (BSA) estimation, based sol ely on patient weight. In comparison with BSA estimations using 2 commonly used methods, which require both weight and height measurements, deviation in the estimate of BSA was less than 10%. This method may be extended to th e dosing of chemotherapeutic agents in infants of body weight less than 10 kg, with appropriate recommendations for dose modification. Until better co rrelates of drug clearance, such as GFR for carboplatin, are identified BSA is used to standardize doses for most chemotherapeutic agents. The formula presented here provides a more robust and reliable method of calculation o f BSA from weight alone. Although this approach has been shown to be equiva lent to other currently used methods, care should be taken extending this c alculation of BSA to children less than 10 kg, to obese patients and to tho se with cachexia. (C) 2001 Cancer Research Campaign.