Chemotherapy Drug Administration

The Candlelighters web page on drugs used in the treatment of childhood cancer (Drugs page) uses shorthand notations for how these drugs are given. An explanation of these terms, common abbreviations, and dose calculations are given below.

Dose Calculations

Chemotherapy drug doses are often given as the amount of drug per Body Surface Area, or BSA. The units of BSA are per square millimeter, or "mm2", or (more properly) "mm2". BSA is calculated from a formula that employs the height and weight of the child. Freireich and Skipper, two early medical researchers studying childhood leukemia, first introduced this concept of chemotherapy agent dose calculation in 1966 (see this part of the Sea to Ara C essay for a little history). Today, several similar algorithms are used to calculate BSA. Online calculators are linked to below.

IV (Intravenous)

IV administration of drugs is a drip (also called infusion) or injection (also called push) directly into a vein. A fine tube can be inserted into the vein for this administration, but most children undergoing treatment for childhood cancer have some type of central line for IV drug administration. A central line is a small tube that goes through the skin of the chest, into a large vein that leads to the heart, and ends in the right atrial chamber of the heart. Central lines not only save children from frequent needle sticks, they prevent damage to veins.

SQ (Subcutaneous)

SQ injections are given just under the skin. Some chemotherapy agents (but not all!) can be given either by IV or SQ, at the option of the parent or physician.

IT (Intrathecal)

IT administration of drugs is injection into the spinal fluid through a lumbar puncture. The doctor inserts a needle into the spinal fluid, in the middle of the back just below the waist, and injects the medication. A spinal can be painful, and the patient must hold very still during the procedure. Most children are sedated for this procedure (see the pain control link below). After the procedure, they must lie flat for 30 minutes (to prevent a headache). Intrathecal administration is also called "LP" (for lumbar puncture) or "spinal".

IM (Intramuscular)

These are shots given directly into the tissue of a muscle.

PO (By Mouth, or Oral)

Pills. Should be simple, but getting young children to take their chemotherapy pills can be a challenge. For ideas on how to get kids to take pills, click on the link below.