多西紫杉醇血药浓度监测在乳腺癌化疗中的临床应用  

The Clinical Application of Therapeutic Drug Monitoring of Docetaxel in Chemotherapy of Breast Cancer

作　　者：曾乌查[1] 施烯[1] 黄铃铃[1] ZENG Wucha;SHI Xi;HUANG Lingling(Department of Oncology,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院化疗一区,福州350005

出　　处：《福建医科大学学报》2018年第6期396-399,共4页Journal of Fujian Medical University

基　　金：福建医科大学苗圃科研基金项目(2015MP027)

摘　　要：目的探讨在乳腺癌患者化疗过程中,多西紫杉醇血药浓度-时间曲线下面积(AUC)水平与疗效及不良反应的相关性。方法 78例乳腺癌患者接受含多西紫杉醇的化疗方案,于每周期多西紫杉醇静脉输注结束前10 min、结束后30～60 min采集血样2次,采用胶乳免疫比浊法检测多西紫杉醇血药浓度。根据计算出的AUC水平,将78例患者分为低AUC组、正常AUC组、高AUC组,比较各组间近期疗效及不良反应发生情况。结果 3组患者近期疗效比较,差别无统计学意义(P>0.05)。3组患者中性粒细胞减少发生率比较,差别存在统计学意义(P<0.05),其中高AUC组的Ⅰ～Ⅳ度粒细胞减少发生率及Ⅲ+Ⅳ度粒细胞减少发生率分别为90.91%和54.55%,明显高于正常AUC组的55.56%和19.05%(P<0.05)。而各组间贫血、血小板减少、乏力、肝功能、恶心呕吐等不良反应发生率比较,差别无统计学意义(P>0.05)。结论多西紫杉醇血药浓度参数AUC与乳腺癌患者应用含多西紫杉醇方案化疗所致粒细胞减少的发生率密切相关。Objective To evaluate the relationship between docetaxel area under concentration-time curve(AUC),efficacy and toxicity in breast cancer patients,and to find a suitable AUC range for breast cancer patients treated with docetaxel.Methods A total of 78 breast cancer patients received chemotherapy regimen containing docetaxel.Plasma concentration of docetaxel was measured by immunoturbidimetry.Patient's docetaxel exposure was determined as AUC using plasma concentrations measured at two different time points(10 minutes before the end of the infusion and 30 to 60 minutes later).Patients were divided into three groups according to AUC,and they were low AUC group,normal range AUC group,and high AUC group.The efficacy and side effects of each group were compared.Results There were no statistical significances in the clinical benefit rates in the three groups.There was a significant difference in the incidence of neutropenia.The incidence of neutropeniaⅠtoⅣfor high AUC group and normal range AUC group was 90.91%and 55.56%,respectively.And neutropeniaⅢtoⅣwas 54.55%and 19.05%,respectively(P=0.017).There were no statistical significances in the incidences of anemia,thrombocytopenia,fatigue,liver function abnormality,nausea,and vomiting.Conclusion The incidence of neutropenia is related to docetaxel AUC in breast cancer patients treated with docetaxel.Further work is needed to define the ideal docetaxel AUC.

关 键 词：乳腺肿瘤 曲线下面积 药代动力学 紫杉烷类 

分 类 号：R737.9[医药卫生—肿瘤]