Question 1

Which BSA formula should I use for chemotherapy dosing?

Accepted Answer

Mosteller is most common. Consistency is essential — use the same formula for dose calculation and protocol validation. Du Bois may overestimate BSA in obese patients.

Question 2

Should BSA be capped in obese patients?

Accepted Answer

Many protocols cap at 2.0–2.2 m², but ASCO recommends using actual BSA with careful toxicity monitoring. For carboplatin, AUC-based dosing is preferred.

Question 3

How do I dose chemotherapy in a patient with body weight changes?

Accepted Answer

Re-calculate BSA if weight changes by >10%. Use the new BSA for the next cycle. For acute cachexia without fluid shifts, consider pre-treatment baseline.

Question 4

Why is BSA used for dose calculation when it has known limitations?

Accepted Answer

BSA-based dosing is practical and remains the standard for most cytotoxic drugs. Alternative strategies (AUC-based, pharmacokinetically-guided) exist but require additional resources.