Schmitt Antonin, Royer Bernard, Boidot Romain, Berthier Joseph, Ghiringhelli François
Pharmacy Department, Centre Georges-François Leclerc, Dijon, France.
Institut National de la Santé et de la Recherche Médicale (INSERM) U1231, University of Burgundy Franche-Comté, Dijon, France.
Front Oncol. 2023 Jun 20;13:1187052. doi: 10.3389/fonc.2023.1187052. eCollection 2023.
Esophageal cancer is a cancer with poor prognosis and the standard 1 line treatment for metastatic or recurrent EC is systemic chemotherapy with doublet chemotherapy based on platinum and 5-fluorouracil (5-FU). However, 5-FU could be a source of severe treatment-related toxicities due to deficiency of dihydropyrimidine dehydrogenase (DPD). In this case report, a 74-year-old man with metastatic esophageal cancer was found to have partial DPD deficiency based on uracilemia measurements (about 90 ng/mL). Despite this, 5-FU was safely administered thanks to therapeutic drug monitoring (TDM). The case report highlights the importance of TDM in administering 5-FU to patients with partial DPD deficiency, as it allows individualized dosing and prevents severe toxicity.
食管癌是一种预后较差的癌症，转移性或复发性食管癌的标准一线治疗是基于铂类和5-氟尿嘧啶（5-FU）的双药联合全身化疗。然而，由于二氢嘧啶脱氢酶（DPD）缺乏，5-FU可能是严重治疗相关毒性的来源。在本病例报告中，一名74岁的转移性食管癌男性患者经尿嘧啶血症测量（约90 ng/mL）发现存在部分DPD缺乏。尽管如此，由于治疗药物监测（TDM），5-FU得以安全给药。该病例报告强调了TDM在给部分DPD缺乏患者使用5-FU时的重要性，因为它允许个体化给药并预防严重毒性。
