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Dose-rounding of adjuvant chemotherapy for breast cancer: an audit of toxicity

Purpose. 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.