氟尿嘧啶化疗行血药浓度监测对结直肠癌化疗效果、毒性作用及预后的预测价值  

Values of Monitoring the Plasma Concentration in Efficacy Prediction of Chemotherapy,Toxicity and Prognoses of Patients with Colorectal Cancer by 5-Fluorouracil Chemotherapy

作　　者：王平[1] 王越[1] 刘学娟 王少红 WANG Ping;WANG Yue;LIU Xue-juan;WANG Shao-hong(Department of Pharmacy,the Affiliated Hospital of Qingdao University,Qingdao,Shandong 266000,China;Department of Medical Supply,Laiyang Hospital of Traditional Chinese Medicine,Laiyang,Shandong 266000,China)

机构地区：[1]青岛大学附属医院药学部,山东青岛266000 [2]莱阳市中医医院供应室,山东莱阳266000

出　　处：《解放军医药杂志》2021年第10期46-49,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：山东省自然科学基金项目(ZR2016MH035)。

摘　　要：目的探讨氟尿嘧啶化疗并进行血药浓度监测对结直肠癌患者疗效、毒性作用及预后生存的预测价值。方法选取2016年1月—2018年1月收治的结直肠癌224例,化疗均采用以氟尿嘧啶为主的FOLFOX6方案,根据氟尿嘧啶血药浓度分为A组(低于靶向范围组)、B组(靶向范围组)、C组(高于靶向范围组),分析不同氟尿嘧啶血药浓度与结直肠癌临床特征、化疗效果、毒性作用的关系及对预后的影响。结果氟尿嘧啶血药浓度与结直肠癌术前癌胚抗原水平、淋巴结转移、表皮生长因子受体、转移器官数目有关(P<0.01)。A组病情稳定率高于B、C组,部分缓解率低于B、C组(P<0.01);A组2、3级毒性作用发生率低于B、C组,且B组3级毒性作用发生率低于C组(P<0.05)。B组预后生存率高于A、C组,A组中位生存时间短于B、C组(P<0.01)。结论氟尿嘧啶血药浓度范围与结直肠癌化疗效果、毒性作用、预后相关,血药浓度位于靶向范围疗效较好。临床加强结直肠癌化疗患者氟尿嘧啶血药浓度监测,有利于及时评估化疗效果及预后、调整药物剂量,减轻毒性作用。Objective To explore values of monitoring the plasma concentration in efficacy prediction of chemotherapy,toxicity and prognostic survival of patients with colorectal cancer(CRC)by 5-Fluorouracil chemotherapy.Methods A total of 224 patients with CRC who had been treated between January 2016 and January 2018 were enrolled.Chemotherapy regimens were mainly 5-Fluorouracil-based FOLFOX6 regimens.The patients were divided into group A(lower than target range group),group B(the target range group)and group C(higher than target range group)according to the plasma concentrations of 5-Fluorouracil.The relationships of different plasma concentrations of 5-Fluorouracil with clinical features,efficacy of chemotherapy,and toxic and side effects,and their effects on prognoses of patients were analyzed.Results The 5-Fluorouracil blood concentration was related to the preoperative carcinoembryonic antigen(CEA)level,lymph node metastasis,epidermal growth factor receptor(EGFR)and the number of metastatic organs(P<0.01).In group A,incidence rate of stable disease(SD)was significantly higher,while partial remission(PR)rate was significantly lower than those in group B and C(P<0.01).Incidence rates of grade 2 and grade 3 toxic effects in group A were significantly lower than those in group B and C(P<0.05),and the incidence rate of grade 3 toxic effects in group B was significantly lower than that in group C(P<0.05).The prognostic survival rate in group B was significantly higher than those in group A and C(P<0.05),and the median survival time in group A was significantly shorter than those in group B and C(P<0.01).Conclusion The range of 5-Fluorouracil blood concentration is related to the efficacy of chemotherapy,toxic effects and prognosis of patients with CRC,and plasma concentration in the target range has better efficacy.Therefore,the detection of 5-Fluorouracil blood concentration in patients with CRC can be strengthened in clinical practice,which is helpful for assessment of the efficacy and prognoses of patients undergoing ch

关 键 词：结直肠肿瘤 氟尿嘧啶 血药浓度 癌胚抗原 治疗效果 毒性作用 预后 

分 类 号：R735.34[医药卫生—肿瘤]