Reply To: Weight change percentage affecting chemotherapy dose adjustment.

  • Myra Woolery

    May 24, 2022 at 10:54 am

    At our institution we use 10% in adults and 5% in pediatrics. We rarely have an issue. When this occurs it has often been for several reasons that easily resolved during the independent double check process. Example of reasons for the discrepancy have included because the LIP was not utilizing the current height/weight for the patient, the dose modification information was not entered into the EMR, a medication that has a predetermined rounding embedded into the clinical trial protocol was not initially identified.




    Myra Woolery, PhD, RN, APRN-CNS, CPON

    Clinical Nurse Specialist

    Neuroscience, Behavioral Health and Pediatrics Nursing Service

    Nursing Department

    Clinical Center

    National Institutes of Health

    Bldg 10 RM 2B-01

    10 Center Drive

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    A Clinical Nurse Specialist (CNS) is a masters or doctoral prepared Advance Practice Registered Nurse (APRN), who is certified, and whose function is to improve outcomes in patient care.
    The CNS is an expert in clinical practice, patient education, research and consultation and influences the three spheres of practice: patient care, nursing and systems.



    Original Message:
    Sent: 5/4/2022 3:46:00 PM
    From: Janet DeJean
    Subject: RE: Weight change percentage affecting chemotherapy dose adjustment.

    We use the 10% and don’t do anything for the 5 – 9%.  I hope this helps!


    Janet DeJean, MSN-Informatics, RN, CPON

    Clinical Specialist

    Texas Children’s Cancer & Hematology Centers

    Texas Children’s Hospital

    6621 Fannin Street |B.0780.18 | Houston, Tx  77030 

    (: 832-822-4870 | Ê: 832-825-4557

    Voalte: 3-4312 | *






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    Original Message:
    Sent: 5/4/2022 2:57:00 PM
    From: Stacy Shourt
    Subject: Weight change percentage affecting chemotherapy dose adjustment.

    This is Stacy Shourt from Upstate University Hospital, NY.  What is the consensus percentage threshold for dose adjusting chemotherapy?  I’ve typically seen a 10% difference in dose, caused by a weight change, as the cut off for notifying providers to adjust chemotherapy.  Are there any institutions using a lower number, like 5%, or do most facilities use the 10% cutoff?  And do any provider groups require notification if the difference is between 5-9%.  I hope I’m asking this clearly enough to be answered, thank you.

    Stacy Shourt, CPNP,RN
    Fayetteville, NY
    United States