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Textbook and Publication Errata
Hazard Warning
From the May 21,1997 Issue
The latest edition of the widely used text, Cancer: Principles and Practice of Oncology, lists a chemotherapy regimen in a manner that could lead to a fatal overdose. In the EPOCH regimen in table 44.6-12 on page 2272, doses are listed as:
| etoposide | 200mg/m2 | IV infusion | days 1 to 4 |
| vincristine | 1.6mg/m2 | IV infusion | days 1 to 4 |
| doxorubicin | 40mg/m2 | IV infusion | days 1 to 4 |
Cyclophosphamide and prednisone are also included
in the regimen.
This method of dose expression is ambiguous. The doses for
etoposide, vincristine, and doxorubicin are course doses which
are supposed to be given as a continuous IV infusion over
a four-day period. Similarly expressed doses have led to errors
in which the entire course dose was administered daily for
4 days. This type of error has happened many times, including
the well known incident in Boston 1995. Instead, the regimen
for etoposide, vincristine and doxorubicin should state:
| etoposide | 50mg/m2/day | IV infusion | days 1 to 4 |
| vincristine | 0.4mg/m2/day | IV infusion | days 1 to 4 |
| doxorubicin | 10mg/m2/day | IV infusion | days 1 to 4 |
Please inform relevant staff and make revisions in library texts at your location. The publisher, J.B. Lippincott, has been informed by ISMP.
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