EpistemisKinetic Principles of Systemic Oncological Treatment
The dosage of cytotoxic agents requires optimization of therapeutic indices due to their reduced selectivity window. Unlike other clinical specialties, chemotherapy dosing is individualized using body surface area parameters and effector organ clearance to limit dose-limiting toxicity (DLT).
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Calculation of Body Surface Area (BSA) and Clearance Index
The estimation of body surface area (BSA) is preferably carried out with the Mosteller formula, clinically validated for its mathematical consistency:
BSA (m2) = √(Height (cm) × Weight (kg))/(3600)
For the analytical determination of glomerular filtration, the Cockcroft-Gault model is applied, adjusting for ideal weight or adjusted in cases of severe obesity, or the CKD-EPI equation model:
ClCr (mL/min) = (140 - Age) × Weight (kg)72 × CrSerum (mg/dL) × [0.85 if female]
The kinetics of tumor growth (Gompertzian model) determines administration in intermittent cycles. This approach allows recovery of hematopoietic stem cells and digestive tract mucosa before the next therapeutic exposure, limiting the occurrence of profound cumulative myelosuppression.
Epistemis is educational review material. It is not a medical device, does not diagnose or prescribe treatment, and does not replace formal medical training, current clinical guidelines, or professional clinical judgment.
- System
- Oncology
- Cluster
- Pharmacokinetic Fundamentals and Dosage