监测氟尿嘧啶血药浓度指导胃癌个体化治疗的应用效果分析

Abstract
Figure/Table
References (15)
Related Citation (15)

Download: PDF (0 KB) HTML (40 KB)
Export: BibTeX | EndNote (RIS)

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.

Key words： Gastric cancer Fluorouracil Plasma drug concentration Capecitabine Individualized treatment

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHOU Lin-ping
	LIU Qiao-zhen

Cite this article:

ZHOU Lin-ping,LIU Qiao-zhen. Analysis of application effect of monitoring Fluorouracil blood concentration to guide the individualized treatment of gastric cancer[J]. 中国当代医药, 2018, 25(23): 13-16.

URL:

http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I23/13

[1]	蔡讯，薛鹏，宋卫峰，等.氟尿嘧啶血尿浓度监测在进一步提高晚期胃癌化疗疗效及减少不良反应预测中的作用[J].肿瘤，2011，31（10）：930-936.
[2]	Patel JN，O′Neil BN，Deal AM，et al.A community-based multicentertrial of pharmacokinetically guided 5-fluorouracil dosing for personalized colorectal cancer therapy[J].Oncologist，2014，19（9）：959-965.
[3]	Song WF，Wang L，Cai X，et al.The relationship between the dose of fluorouracil and it′s plasma concentration and the survival of patients with advanced colorectal cancer[J].Tumor，2013，33（9）：820-829.
[4]	Saam J，Critchfield GC，Hamilton SA，et al.Body surface are a-based dosing of 5-fluorouracil results in extensive interindividual variability in 5-fluorouracil exposure in colorectal cancer patients on FOLFOX regimens[J].Clin Colorectal Cancer，2011，10（3）：203-206.
[5]	董秋美，黄赛花，郑伟华，等.高效液相色谱法检测结直肠癌患者5-FU血药浓度的临床意义[J].中华肿瘤防治杂志，2010，17（18）：1476-1478，1481.
[6]	Gamelin E，Delva R，Jacob J，et al.Individual fluorouracil doseadjustment based on pharmacokinetic follow-upcompared with conventionaldosage：results of a multicenter randomized trail of patients with metastatic colorectal cancer[J].J Clin Oncol，2008，26（13）：2099-2105.
[7]	Chen XD，He FQ，Chen M，et al.Can S-1 orouracil for advanced gastric cancer?A PRISMA-compliant systematic review and meta-analysis[J].Medicine，2016，95（24）：e3916.
[8]	李莉霞，卜书红，李方，等.卡培他滨和5-氟尿嘧啶治疗结直肠癌药物经济学评价[J].中国临床药学杂志，2015，24（1）：23-26.
[11]	张红雨，赵春临，叶延伟，等.氟尿嘧啶血药浓度监测对于直肠癌患者化疗疗效的研究进展[J].河南医学研究，2016，2（25）：260-262.
[12]	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.
[13]	梁淑影，王峰，王珺，等.5-氟尿嘧啶血药浓度对替吉奥联合紫杉醇治疗晚期胃癌疗效的评估价值[J].郑州大学学报（医学版），2017，52（3）：339-343.
[9]	Wagner AD，Grothe W，Haerting J，et al.Chemo-therapy in advanced gastric cancer：a systematic review and meta-analysis based on aggregate data[J].J Clin Oncol，2016，24（18）：2903.
[10]	Montange D，Bérard M，Demarchi M，et al.An APCILCMS/MS method for routine determination of capecitabine and its metabolites in human plasma[J].J Mass Spectrom，2010，45（6）：670-677.
[14]	刘佳宁，李磊，崔永霞，等.晚期结直肠癌患者5-氟尿嘧啶药代动力学参数AUC与不良反应及近期疗效的相关性分析[J].中华实用诊断与治疗杂志，2016，30（3）：301-303.
[15]	姚伟荣，万会平，喻燕敏，等.5-氟尿嘧啶和多西紫杉醇稳态血药浓度影响化疗不良反应及近期疗效[J].肿瘤防治研究，2014，41（1）：53-56.