Abstract：Objective To explore the significance of the combined chemotherapy in guiding individualized treatments of advanced gastric cancer,and to observe its association with both the efficacy and toxic and adverse effects by monitoring and regulating the concentration of Fluorouracil in patients′peripheral blood.Methods A total of 40 patients with stageⅢ-Ⅳ gastric cancer from June 2015 to May 2017 in our hospital were selected as objects and randomly divided into the control group and the experimental group,with 20 cases in each group.The two groups were treated with Oxaliplatin combined with Capecitabine for first line chemotherapy,at least 4 cycles and above.In the first cycle,all patients were given drugs in the traditional body surface area (BSA)manner.From the beginning of the second cycle to the end of chemotherapy,the control group still was given the way of BSA administration,while in the experimental group,the drug dose of Fluorouracil for the post-chemotherapy cycle was adjusted according to the plasma drug concentration of Fluorouracil and the pharmacological parameters of Fluorouracil obtained in the first cycle of chemotherapy.The efficacy and safety of two groups were compared.Results The blood target concentration of Fluorouracil in patients was 200-250 ng/ml.The concentration of Fluorouracil in patients of the experimental group was basically adjusted to the steady state during the fourth cycle of chemotherapy,which was 200-250 ng/ml,in the control group,only 5%of the patients reached the target concentration,and the difference was statistically significant(P＜0.05).The incidence of myelosuppression and hand-foot syndrome in the experimental group were significantly superior to those of the control group,and the difference was statistically significant(P＜0.05).There was no significant difference in the incidence of gastrointestinal reactions,diarrhea,and mucositis between two groups(P＞0.05).The total reaction rate of the experimental group was 65.00%,which was significantly higher than that in the control group (25.00%),and the difference was statistically significant(P＜0.05).The PFS and OS of the experimental group were 13.5 and 8.5 months,which were respectively longer than that in the control group(10.0 and 6.0 months),and the differences were statistically significant(P＜0.05).Conclusion In patients with advanced gastric cancer treated with Oxaliplatin combined with Capecitabine chemotherapy,patients with Fluorouracil steady state blood concentration maintained 200-250 ng/ml are well tolerated and have better survival benefit.
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