晚期结直肠癌患者氟尿嘧啶血药浓度监测的回顾性分析。
A retrospective analysis of plasma concentration monitoring of fluorouracil in patients with advanced colorectal cancer.
机构信息
Oncology, Changzhou Cancer Hospital, Soochow University, Changzhou, China.
Laboratory Medicine, Changzhou Cancer Hospital, Soochow University, Changzhou, China.
出版信息
Eur J Hosp Pharm. 2020 Mar;27(e1):e36-e40. doi: 10.1136/ejhpharm-2019-001862. Epub 2019 Mar 16.
OBJECTIVES
To analyse the results of fluorouracil (5-FU) plasma concentration monitoring in patients with advanced colorectal cancer after 5-FU treatment, and to provide a reference for the application prospect of 5-FU plasma concentration monitoring technology.
METHODS
A retrospective analysis was performed with advanced colorectal cancer patients treated with 5-FU from March 2015 to August 2018. The results of plasma concentration monitoring of 5-FU, severe adverse reactions, and anti-tumour efficacy were analysed.
RESULTS
Among 47 patients, 5-FU plasma concentration monitoring was carried out a total of 289 times. The area under the receiver operating characteristic (ROC) curve (AUC) reflecting 5-FU exposure in vivo was 2.8-158 mgh/L (41±94.6 mgh/L). Mean AUC range within the target range (20-30 mgh/L) for each patient was observed in 28.8% of patients. The overall incidence of related severe adverse reactions in the AUC ≤30 mgh/L group was lower than that in the >30 mgh/L group (24.0% and 50.0%, respectively) (p=0.06), and the incidence of severe neutropenia was 12.0% and 40.9%, respectively (p=0.05). The disease control rate and overall response rate of the AUC <20 mgh/L group was lower than that of the ≥20 mg*h/L group: 83.3% vs 97.1% (p=0.19) and 25.0% vs 51.4% (p = 0.10), respectively.
CONCLUSIONS
The 5-FU plasma concentration monitoring technique can improve the safety and efficacy of 5-FU administration to advanced colorectal cancer patients. It is expected to become an important means to individualise 5-FU use in the Chinese population.
目的
分析氟尿嘧啶（5-FU）治疗晚期结直肠癌患者后 5-FU 血浆浓度监测的结果，为 5-FU 血浆浓度监测技术的应用前景提供参考。
方法
回顾性分析 2015 年 3 月至 2018 年 8 月期间接受 5-FU 治疗的晚期结直肠癌患者。分析 5-FU 血浆浓度监测结果、严重不良反应和抗肿瘤疗效。
结果
47 例患者共进行 289 次 5-FU 血浆浓度监测。反映体内 5-FU 暴露的受试者工作特征曲线（ROC）下面积（AUC）为 2.8-158mgh/L（41±94.6mgh/L）。观察到 28.8%的患者每个患者的目标范围内（20-30mgh/L）的平均 AUC 范围。AUC≤30mgh/L 组的相关严重不良反应总发生率低于 AUC＞30mgh/L 组（24.0%和 50.0%，分别）（p=0.06），严重中性粒细胞减少症的发生率分别为 12.0%和 40.9%（p=0.05）。AUC＜20mgh/L 组的疾病控制率和总反应率低于 AUC≥20mg*h/L 组：83.3%比 97.1%（p=0.19）和 25.0%比 51.4%（p=0.10）。
结论
5-FU 血浆浓度监测技术可以提高晚期结直肠癌患者 5-FU 给药的安全性和疗效。有望成为中国人群 5-FU 个体化应用的重要手段。
Zotero 插件