Oncology, Changzhou Cancer Hospital, Soochow University, Changzhou, China.
Laboratory Medicine, Changzhou Cancer Hospital, Soochow University, Changzhou, China.
Eur J Hosp Pharm. 2020 Mar;27(e1):e36-e40. doi: 10.1136/ejhpharm-2019-001862. Epub 2019 Mar 16.
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.
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.
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.
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.
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。
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。
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）。
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。
