Field Kathryn M, Dow Chris, Michael Michael
Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Locked Bag 1, VIC, Australia.
Lancet Oncol. 2008 Nov;9(11):1092-101. doi: 10.1016/S1470-2045(08)70279-1.
The liver has a key role in the metabolism (ie, inactivation or activation) of many commonly used anticancer agents-cytotoxics or new biological agents. Therefore, assessment of liver function is a fundamental part of initial work-up and management of patients with cancer. An understanding of the meaning of conventional serum biochemical testing of liver function and status, what variables they are measuring, and usefulness for chemotherapy dosing is essential. Emerging awareness of the drawbacks of conventional serum biochemical testing and further understanding of the intricacies of liver function is leading to the development of alternative strategies for appropriate chemotherapy regimens and dosing. We present an overview of assessment of liver function and chemotherapy dosing. We consider the use of serum liver biochemical testing to predict liver function, potential causes of biochemical abnormalities in patients with cancer, and chemotherapy drugs that are associated with hepatotoxicity. Part II will overview the current knowledge surrounding chemotherapy dosing in the setting of liver dysfunction; as well as alternative tests of hepatic metabolic function that are beginning to be used as strategies for appropriate individualised chemotherapy administration.
肝脏在许多常用抗癌药物（细胞毒性药物或新型生物制剂）的代谢（即灭活或激活）过程中起着关键作用。因此，肝功能评估是癌症患者初始检查和管理的基本组成部分。了解传统肝功能血清生化检测的意义、它们所测量的变量以及对化疗剂量的作用至关重要。对传统血清生化检测缺点的新认识以及对肝功能复杂性的进一步理解，正促使人们开发用于制定合适化疗方案和剂量的替代策略。我们概述了肝功能评估和化疗剂量确定。我们考虑使用血清肝脏生化检测来预测肝功能、癌症患者生化异常的潜在原因以及与肝毒性相关的化疗药物。第二部分将概述目前关于肝功能不全情况下化疗剂量确定的知识；以及开始被用作制定合适个体化化疗给药策略的肝脏代谢功能替代检测方法。
