Effect of 5-fluorouracil blood concentration monitoring on individualized treatment in patients with gastrointestinal tumors#br#
GUO Nannan ZHAO Feng WU Yiting LIU Yanwen
Department of Internal Medicine-Oncology, Jiangbei Hospital, Zhongda Hospital Affiliated to Southeast University, Jiangsu Province, Nanjing 221200, China
Abstract：Objective To investigate the effect of 5-fluorouracil (5-Fu) blood concentration monitoring on individualized treatment in patients with gastrointestinal tumors. Methods A total of 54 patients with gastrointestinal tumors who were admitted to Zhongda Hospital Affiliated to Southeast University from November 2019 to August 2020 were selected as the research objects, they were divided into control group and study group by random number table method, with 27 cases in each group. Both groups were treated with FOLFOX6 regimen for chemotherapy. In the first cycle of chemotherapy, both groups were given the traditional body surface area (BSA) based chemotherapy. From the second cycle to the end of chemotherapy, the control group were still treated with BSA. In the study group, the dose of drug was adjusted from the second cycle to the end of chemotherapy based on the plasma drug concentration and pharmacological parameter(area under the curve) of 5-FU in the first cycle of chemotherapy. The distribution of 5-Fu plasma drug concentration, chemotherapy effect and adverse reactions between the two groups in the fourth cycle of chemotherapy were compared. Results There were significant difference in the proportion of 5-Fu plasma drug concentration distribution between the two groups (P ＜ 0.05). After four cycles of chemotherapy, the overall response rate of the study group was significantly higher than that of the control group (P ＜ 0.05). There was no significant difference in the incidence of grade Ⅰ-Ⅱ bone marrow suppression, and hand-foot syndrome, grade Ⅲ-Ⅳ mucositis, and hand-foot syndrome between the two groups (P ＞ 0.05); The incidence of grade Ⅰ-Ⅱ diarrhea, gastrointestinal reaction, mucositis, and grade Ⅲ-Ⅳ diarrhea, gastrointestinal reaction, and bone marrow suppression in the study group was significantly lower than that in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion Monitoring the plasma drug concentration of 5-Fu in patients with gastrointestinal tumors can provide dosage basis for individualized treatment, improve the chemotherapy effect of individualized treatment and reduce the incidence of adverse reactions.
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