中国非小细胞肺癌患者培美曲塞联合卡铂化疗剂量的影响因素  

The influence factors of chemotherapy dose for patients with non-small cell lung cancer in China

作　　者：杨珺 陈伟 李国辉 YANG Jun;CHEN Wei;LI Guo-hui(Department of Pharmacy,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学中心/中国医学科学院北京协和医学院肿瘤医院药剂科,北京100021

出　　处：《临床药物治疗杂志》2018年第6期56-60,65,共6页Clinical Medication Journal

基　　金：中国医学科学院医学与健康科技创新工程(2017-I2M-2-003)

摘　　要：目的:通过分析临床非小细胞肺癌化疗剂量的分布情况,寻找影响临床化疗剂量的相关因素,为临床药师化疗医嘱审核及临床用药分析提供参考依据。方法:调取2015年中国医学科学院北京协和医学院肿瘤医院肿瘤内科收治的所有非小细胞肺癌患者病历,以培美曲塞联合卡铂化疗的肺腺癌患者为研究对象,通过分析患者基本信息、功能状态评分、合并症、化疗疗效与毒性反应、化疗方案和化疗药物剂量,分析临床选择化疗剂量的影响因素。结果:采用培美曲塞联合卡铂化疗方案的221例患者共接受了704周期的化疗,培美曲塞的给药剂量平均值为(507.70±37.38)mg·m^(-2),最大剂量为629 mg·m^(-2),最小剂量为349 mg·m^(-2);卡铂给药的曲线下的面积(area under curve,AUC)平均值为3.93±0.62,最大值为5.54,最小值为2.16;化疗剂量的选择与患者年龄、基础疾病(糖尿病)、不同医生有关(P<0.05)。结论:培美曲塞化疗剂量与指南推荐基本一致,而卡铂则低于指南的推荐剂量;临床药师在审核化疗医嘱化疗剂量时应考虑国内外患者的差异以及个体差异。Objective： To analyze the distribution of chemotherapy dosage in clinical non-small cell lung cancer, find out the related factors that affect the dosage of clinical chemotherapy, and provide the reference for clinical pharmacists＇ medical advice and clinical medication analysis. Methods： We collected the medical record of patients with non-small cell lung cancer（NSCLC） who treated using pemetrexed combined with carboplatin in the hospital HIS system in 2015. The influencing factors of drug dosage was analyzed according to the basic information, functional status score, complication, therapeutic effect and toxicity, chemotherapy regimen and dose. Results： Seven hundred and four chemotherapy cycles of221 patients who were treated by pemetrexed combined with carboplatin. The average dose of pemetrexed was（507 ±37.38） mg · m^（-2）, and the maximum and minimum dose was 629 mg · m^（-2）and 349 mg · m^（-2） respectively; the average area under curve（AUC） of carboplatin was 3. 93 ±0.62,and themaximum and minimum value was 5. 54 and 2.16 respectively. Correlation factor analysis showed that dosage adjustment was related to age, basic disease（diabetes）, and different doctors（P〈 0. 05）. Conclusion： The dose of pemetrexine was basically consistent with the recommended guidelines,while carboplatin was lower than the recommended When reviewing the chemotherapy dosage, clinical pharmacists should take into account the differences between domestic and foreign patients, and the possible influence on individual differences.

关 键 词：化疗剂量 培美曲塞 卡铂 回顾性分析 非小细胞肺癌 

分 类 号：R979.1[医药卫生—药品]