A Cross-Sectional Study Comparing Variation in Body Surface Area and Chemotherapy Dosing in Pediatric Oncology Using Two Different Methods

Abstract: Standardizing Body Surface Area (BSA) determination is essential for avoiding variation in chemotherapy dosage calculations. In this study we compared variation in BSA calculation using weight and height by the Mosteller formula with weight alone using recently adapted table at the Princess Norah Oncology Center (PNOC).

Methods: Cross-sectional study of pediatric oncology patients presenting to the pediatric oncology clinic at PNOC over a week period of time.

Results: One hundred consecutive pediatric oncology patients presented to the clinic. The mean BSA calculated by the Mosteller formula was 0.83m² (Standard Deviation = 0.24) and the mean BSA determined by the table (based on weight alone) was 0.82m² (Standard Deviation = 0.25). The mean variation in dosing between the two methods was 1.64% (Standard Deviation = 3.4). Only 13 out of 100 patients (13%) had equal dosing using both methods and 21 out of 100 patients (21%) had dosing variation greater than 5%. When comparing both methods, using paired t-test, the difference was statistically significant (t₍₉₉₎ = 3.99 and P < 0.001).

Conclusion: Significant differences in BSA-based chemotherapy dosing exist in our center. The Mosteller method should remain the standard until prospective studies are performed to determine the significance of this dosing variability on toxicity and survival outcome.