How to calculate the dose of chemotherapy

Body surface area-dosing does not account for the complex processes of cytotoxic drug elimination. This leads to an unpredictable variation in effect. Overdosing is easily recognised but it is possible that unrecognised underdosing is more common and may occur in 30% or more of patients receiving standard regimen. Those patients who are inadvertently underdosed are at risk of a significantly reduced anticancer effect. Using published data, it can be calculated that there is an almost 20% relative reduction in survival for women receiving adjuvant chemotherapy for breast cancer as a result of unrecognised underdosing. Similarly, the cure rate of cisplatin-based chemotherapy for advanced testicular cancer may be reduced by as much as 10%. The inaccuracy of body surface area-dosing is more than an inconvenience and it is important that methods for more accurate dose calculation are determined, based on the known drug elimination processes for cytotoxic chemotherapy. Twelve rules for dose calculation of chemotherapy are given that can be used as a guideline until better dose-calculation methods become available. Consideration should be given to using fixed dose guidelines independent of body surface area and based on drug elimination capability, both as a starting dose and for dose adjustment, which may have accuracy, safety and financial advantages

Variability of humidity conditions in the Arctic during the first International Polar Year, 1882-83

Of all the early instrumental data for the Arctic, the meteorological data gathered during the first International Polar Year, in 1882–83 (IPY-1), are the best in terms of coverage, quality and resolution. Research carried out during IPY-1 scientific expeditions brought a significant contribution to the development of hygrometry in polar regions at the end of the 19th century. The present paper gives a detailed analysis of a unique series of humidity measurements that were carried out during IPY-1 at hourly resolutions at nine meteorological stations, relatively evenly distributed in the High Arctic. It gives an overall view of the humidity conditions prevalent in the Arctic at that time. The results show that the spatial distribution of atmospheric water vapour pressure (e) and relative humidity (RH) in the Arctic during IPY-1 was similar to the present. In the annual course the highest values of e were noted in July and August, while the lowest occurred in the cold half of the year. In comparison to present-day conditions (1961–1990), the mean values of RH in the IPY-1 period (September 1882 to July 1883) were higher by 2.4–5.6%. Most of the changes observed between historical and modern RH values are not significant. The majority of historical daily RH values lie between a distance of less than two standard deviations from current long-term monthly means