Dose-rounding of adjuvant chemotherapy for breast cancer: an audit of toxicity.
OBJECTIVE
dose-rounding of chemotherapy is increasingly being used in oncology departments to improve the efficiency of outpatient clinics. There is, however, no published data on the effect of this strategy on drug toxicity.


METHODS
we have analysed acute chemotherapy side effects in a cohort of 662 consecutive patients receiving adjuvant FEC (5-fluorouracil, epirubicin, cyclophosphamide) for breast cancer. A dose-rounding algorithm was used to deliver drug doses that were within 5% of the standard dose based on body surface area.


RESULTS
patients receiving a rounded dose of chemotherapy that was higher than that calculated from their body surface area were not at increased risk of acute haematological or non-haematological toxicity.


CONCLUSIONS
dose-rounding of adjuvant FEC within the range ± 5% is not associated with any difference in acute chemotherapy side effects. Longer term follow-up is required to determine whether patients receiving rounded doses below that calculated from their body surface area are at increased risk of relapse.
Jenkins
Peter
P
Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham, GL53 7AN, UK. peter.jenkins@glos.nhs.uk
Wallis
Richard
R
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D001830:Body Surface Area; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D054796:Drug Dosage Calculations; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D055815:Young Adult
D000970:Antineoplastic Agents; D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil