消化道肿瘤患者5-氟尿嘧啶血药浓度监测对个体化治疗的影响

Abstract
Figure/Table
References (24)
Related Citation (12)

Download: PDF (674 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

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.

Key words： Gastrointestinal tumor 5-Fluorouracil Plasma drug concentration Individualized treatment

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	GUO Nannan ZHAO Feng WU Yiting LIU Yanwen

Cite this article:

GUO Nannan ZHAO Feng WU Yiting LIU Yanwen. Effect of 5-fluorouracil blood concentration monitoring on individualized treatment in patients with gastrointestinal tumors#br#[J]. 中国医药导报, 2022, 19(11): 107-110.

URL:

https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I11/107

[1] 张丽燕，国仁秀，梁亚茹，等.消化道肿瘤患者化疗相关性味觉改变及对营养和生活质量的影响[J].护理学杂志，2019，34（21）：80-82.
[2] 李然，马旭，白羽，等.奥沙利铂在消化道肿瘤患者中药物相关基因单核苷酸多态性及化疗不良反应相关性研究[J].中国医院药学杂志，2020，40（2）：203-207.
[3] 卢元丽，张志国，张颖，等.晚期消化道肿瘤患者化疗前后外周血中MDSCs亚群的变化[J].免疫学杂志，2020， 36（11）：93-98.
[4] 章金鹏，杨亚东，杨志勇.消化道肿瘤患者化疗后骨髓抑制期感染特点及危险因素分析[J].中国肿瘤临床与康复，2019，26（6）：719-722.
[5] 何启雄，李刚，吴志扬，等.消化道恶性肿瘤患者预后影响因素分析和预测模型的构建[J].广西医科大学学报，2019，36（5）：763-766.
[6] 杨东海.晚期结直肠癌患者5-Fu AUC理想区间值的研究[J].重庆医学，2017，14（46）：115-118.
[7] 涂碎萍，李获，陈岷，等.LC-MS测定结直肠癌患者血浆中5-氟尿嘧啶浓度[J].实用药物与临床，2018，21（9）：1047-1051.
[8] Yang Q，Bi Y，Li X，et al. A retrospective analysis of plasma concentration monitoring of fluorouracil in patients with advanced colorectal cancer [J]. Eur J Hosp Pharm，2019，27：e36-e40.
[9] 章海斌，王子安.FOLFOX6方案中5-氟尿嘧啶稳态血药浓度与个体药理差异及毒性相关性研究[J].蚌埠医学院学报，2017，42（5）：582-584.
[10] 王海霞，王燕.FOLFOX4化疗方案对中晚期胃癌患者生活质量和免疫功能的影响[J].中国肿瘤临床与康复，2018，25（9）：43-46.
[11] 王德猛，刘胜军，朱继敏.替吉奥治疗老年晚期胃癌的近期疗效分析与安全性评估[J].中华保健医学杂志，2017（19）：486-488.
[12] Kaldate RR，Haregewoin A，Grier CE，et al． Modeling the 5-FU area under the curve cersus dose relationship to develop a pharmacokinetic dosing algorithm for colorectal cancer patients receiving FOLFOX6 [J]. Oncologist，2012，17（3）：296．
[13] 李军华，贾向东，许天祥，等. Sestrin 2促进胃癌细胞生长并提高其耐药性[J].肿瘤，2019，39（10）：27-35，44.
[14] 袁航，任统伟.周小剂量卡铂（CBP）联合低剂量氟脲嘧啶对高龄晚期结肠癌患者的疗效和安全性[J].实用癌症杂志，2017，32（1）：84-86.
[15] Macaire P，Morawska K，Vincent J，et al. Therapeutic drug monitoring as a tool to optimize 5-FU-based chemotherapy in gastrointestinal cancer patients older than 75 years [J]. Eur J Cancer，2019，111（5）：116-125.
[16] Yu A，Sakuyama N，Sato T，et al. Evaluation of the 5-fluorouracil plasma level in patients with colorectal cancer undergoing continuous infusion chemotherapy [J]. Mol Clin Oncol，2019，11（3）：289-295.
[17] 陈国栋，殷荣华.Xelox方案联合甲地孕酮对消化道肿瘤的疗效及对IL-6，TNF-α细胞因子水平的影响[J].实用癌症杂志，2019，34（11）：31-33.
[18] 范先煜，汪硕闻，汪雯心，等.LC-MS/MS法同时测定人血浆中伊立替康与其主要代谢产物及在治疗药物监测中的应用[J].中南药学，2020，18（6）：16-21.
[19] Kuwahara A，Kobuchi S，Tamura T. Association between circadian and chemotherapeutic cycle effects on plasma concentration of 5-fluorouracil and the clinical outcome following definitive 5-fluorouracil/cisplatin-based chem-oradiotherapy in patients with esophageal squamous cell carcinoma [J]. Oncol Lett，2019，17（1）：668-675.
[20] 印妮，王雨雯，唐雨曼，等.基于氟尿嘧啶类药物化疗的异常糖链糖蛋白在胃肠道恶性肿瘤中表达[J].中国药学杂志，2019，54（24）：2093-2096.
[21] 何光照，薛宏波，杨全良，等.氟尿嘧啶血药浓度检测方法的建立及其临床应用[J].中国药师，2017，20（1）：49-52.
[22] 张柳，衡艳林，胡红.肿瘤患者口服化疗药依从性影响因素的研究进展[J].护士进修杂志，2019，34（5）：422-425.
[23] 徐琨.不同剂量替加氟对肿瘤患者代谢及不良反应的影响[J].肿瘤基础与临床，2019，32（5）：30-33.
[24] 卢创新，郑博文，白冰，等.结直肠癌患者应用奥美拉唑注射液对卡培他滨血药浓度及其毒副反应和疗效的影响[J].中华肿瘤杂志，2019，41（9）：708-711.