FOLFOX6方案中5-氟尿嘧啶稳态血药浓度与个体药理差异及毒性相关性研究

章海斌; 王子安

doi:10.13898/j.cnki.issn.1000-2200.2017.05.006

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FOLFOX6方案中5-氟尿嘧啶稳态血药浓度与个体药理差异及毒性相关性研究

章海斌 , 王子安

文章导航 > 蚌埠医学院学报 > 2017, 42 > 5: (582-584)

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Citation:

FOLFOX6方案中5-氟尿嘧啶稳态血药浓度与个体药理差异及毒性相关性研究

蚌埠医学院第一附属医院肿瘤内科, 安徽蚌埠 233004

作者简介: 章海斌(1991-),女,硕士研究生.

基金项目:
蚌埠医学院研究生科研创新计划项目（Byycx1541）
中图分类号: R735.3

Study on the correlation between 5-Fu steady-state blood concentration in FOLFOX6 scheme,and individual pharmacological difference and toxicity

Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R735.3

摘要: 目的：检测接受奥沙利铂+亚叶酸钙+5-氟尿嘧啶（5-Fu）（FOLFOX6）方案化疗的晚期结直肠病人5-Fu血药浓度-时间曲线下面积（AUC），分析AUC在降低不良反应发生率，提高治疗效果方面的相关性。方法：选取以FOLFOX6方案化疗的晚期结直肠癌病人40例，随机分为对照组和观察组，各20例。基于体表面积（BSA）给药，接受2个周期化疗。第1周期所有病人均以传统的BSA给药方式，第2周期开始至化疗结束，对照组仍采用BSA给药方式，观察组在化疗第1周期5-Fu静脉泵入18～30 h内采集外周静脉血测5-Fu血药浓度，并根据5-Fu的AUC调整第2周期用药剂量。2个周期化疗结束后比较2组病人出现的不良反应及疗效情况。结果：2组Ⅰ～Ⅱ级腹泻、胃肠道反应、黏膜炎发生率及Ⅲ～Ⅳ级骨髓抑制、胃肠道反应发生率差异均有统计学意义（P<0.05）；2组Ⅰ～Ⅱ级骨髓抑制、手足综合征发生率及Ⅲ～Ⅳ级腹泻、黏膜炎、手足综合征发生率差异均无统计学意义（P>0.05）。观察组总体反应率（60.00%）高于对照组的25.00%（P<0.05）。结论：实时监测接受FOLFOX6方案化疗的晚期结直肠癌病人5-Fu血药浓度，并根据AUC调整用药剂量，将有效降低不良反应，提高治疗效果。
- 结直肠肿瘤 /
- 血药浓度 /
- 5-氟尿嘧啶
Abstract: Objective: To investigate the plasma concentration of 5-fluorouracil(5-Fu) and area under time curve(AUC) in FOLFOX6[oxaliplatin,calcium folinate and 5-Fu scheme treating advanced colorectal cancer,analyze the correlations between AUC,and reducing the incidence of adverse reaction and improving the therapeutic effect.Methods: Forty advanced colorectal cancer patients treated with FOLFOX 6 scheme were randomly divided into the control group and observation group(20 cases each group).Two groups were treated with chemotherapy for two cycles based on body surface area(BSA) administration.The control group was treated with traditional administration mode during two cycles.The observation group was treated with 5-Fu by intravenous infusion for 18 to 30 h in the first cycle,and adjusted dosage of 5-Fu according to the AUC of 5-Fu in the second cycle.The adverse reactions and efficacy between two groups were compared after chemotherapy.Results: The differences of the incidence rates of leveⅠ to Ⅱ diarrhea,gastrointestinal reaction,mucositis and level Ⅲ to Ⅳ myelosuppression between two groups were statistically significant(P<0.05).The differences of the incidence rates of level Ⅰ to Ⅱ myelosuppression,hand-foot syndrome and level Ⅲ to Ⅳ diarrhea between two groups were not statistically significant(P>0.05).The total reaction rate of observation group(60.00%)was higher than the control group(25.00%)(P<0.05).Conclusions: Real-time monitoring the 5-Fu blood concentration in advanced colorectal cancer patients treated with FOLFOX6 chemotherapy and adjusting the dose of 5-Fu according to the AUC can effectively reduce the adverse reaction,and improve the therapeutic effect.
- colorectal neoplasms /
- plasma-drug concentration /
- 5-fluorouracil

[1]	李道娟,李倩,贺宇彤.结直肠癌流行病学趋势[J].肿瘤防治研究,2015,42(3):305.
[2]	宋卫峰,王雷,蔡讯,等.晚期结直肠癌病人氟尿嘧啶剂量与血药浓度和生存的关系[J].肿瘤,2013,33(9):820.
[3]	SAAM J,CRICHFIELD GC,HAMILTON SA,et al.Body surface areabased dosing of 5-fluorouracil results in extensive interindividual variability in 5-fluorouracil exposure in colorectal cancer patients on FOLFOX regimens[J].Clin Colorectal Cancer,2011,10(3):203.
[4]	KALDATE RR,HAREGEWOIN A,GRIER CE,et al.Modeling the 5-FU area under the curve cersus dose relationship to develop a pharmacokinetic dosing algorithm for colorectal cancer patients receiving FOLFOX6[J].Oncologist,2012,17(3):296.
[5]	刘杨.奥沙利铂联合替吉奥治疗晚期大肠癌疗效观察[J].中华实用诊断与治疗杂志,2014,28(10):1035.
[6]	UNDEVIA SD,GOMEZ-ABUIN G,RATAIN MJ,et al.Pharmacokinetic variability of anticancer agents[J].Nature Rev Cancer,2005,5(6):447.
[7]	KIRKWOOD JM,ENSMINGER W,ROSOWSKY A,et al.Comparison of pharmacokinetics of 5-fluorouracil and 5-fluorouracil concurrent thymidine infusions in a Phase I trial[J].Cancer Res,1980,40(1):107.
[8]	GAMELIN E,DELVA R,JACOB J,et al.Individual 5-fluorouracil dose adjustment based on pharmacokinetic follow-up compared with conventional dosage:results of a multicenter randomized trial in patients with metastatic colorectal cancer[J].J Clin Oncol,2008,26(13):2099.
[9]	张红雨,赵春临,叶延伟.氟尿嘧啶血药浓度监测对于结直肠癌病人化疗疗效的研究进展[J].河南医学研究,2016,25(2):260.
[10]	智玲玲,李智英.奥沙利铂联合5-FU/亚叶酸钙改良时辰化疗治疗晚期结直肠癌疗效观察[J].医药论坛,2014,35(1):61.

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FOLFOX6方案中5-氟尿嘧啶稳态血药浓度与个体药理差异及毒性相关性研究

作者简介: 章海斌(1991-),女,硕士研究生.

蚌埠医学院第一附属医院肿瘤内科, 安徽蚌埠 233004

收稿日期: 2016-12-31

基金项目: 蚌埠医学院研究生科研创新计划项目（Byycx1541）

关键词:

摘要: 目的：检测接受奥沙利铂+亚叶酸钙+5-氟尿嘧啶（5-Fu）（FOLFOX6）方案化疗的晚期结直肠病人5-Fu血药浓度-时间曲线下面积（AUC），分析AUC在降低不良反应发生率，提高治疗效果方面的相关性。方法：选取以FOLFOX6方案化疗的晚期结直肠癌病人40例，随机分为对照组和观察组，各20例。基于体表面积（BSA）给药，接受2个周期化疗。第1周期所有病人均以传统的BSA给药方式，第2周期开始至化疗结束，对照组仍采用BSA给药方式，观察组在化疗第1周期5-Fu静脉泵入18～30 h内采集外周静脉血测5-Fu血药浓度，并根据5-Fu的AUC调整第2周期用药剂量。2个周期化疗结束后比较2组病人出现的不良反应及疗效情况。结果：2组Ⅰ～Ⅱ级腹泻、胃肠道反应、黏膜炎发生率及Ⅲ～Ⅳ级骨髓抑制、胃肠道反应发生率差异均有统计学意义（P<0.05）；2组Ⅰ～Ⅱ级骨髓抑制、手足综合征发生率及Ⅲ～Ⅳ级腹泻、黏膜炎、手足综合征发生率差异均无统计学意义（P>0.05）。观察组总体反应率（60.00%）高于对照组的25.00%（P<0.05）。结论：实时监测接受FOLFOX6方案化疗的晚期结直肠癌病人5-Fu血药浓度，并根据AUC调整用药剂量，将有效降低不良反应，提高治疗效果。

English Abstract

Study on the correlation between 5-Fu steady-state blood concentration in FOLFOX6 scheme,and individual pharmacological difference and toxicity

Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2016-12-31

Abstract: Objective: To investigate the plasma concentration of 5-fluorouracil(5-Fu) and area under time curve(AUC) in FOLFOX6[oxaliplatin,calcium folinate and 5-Fu scheme treating advanced colorectal cancer,analyze the correlations between AUC,and reducing the incidence of adverse reaction and improving the therapeutic effect.Methods: Forty advanced colorectal cancer patients treated with FOLFOX 6 scheme were randomly divided into the control group and observation group(20 cases each group).Two groups were treated with chemotherapy for two cycles based on body surface area(BSA) administration.The control group was treated with traditional administration mode during two cycles.The observation group was treated with 5-Fu by intravenous infusion for 18 to 30 h in the first cycle,and adjusted dosage of 5-Fu according to the AUC of 5-Fu in the second cycle.The adverse reactions and efficacy between two groups were compared after chemotherapy.Results: The differences of the incidence rates of leveⅠ to Ⅱ diarrhea,gastrointestinal reaction,mucositis and level Ⅲ to Ⅳ myelosuppression between two groups were statistically significant(P<0.05).The differences of the incidence rates of level Ⅰ to Ⅱ myelosuppression,hand-foot syndrome and level Ⅲ to Ⅳ diarrhea between two groups were not statistically significant(P>0.05).The total reaction rate of observation group(60.00%)was higher than the control group(25.00%)(P<0.05).Conclusions: Real-time monitoring the 5-Fu blood concentration in advanced colorectal cancer patients treated with FOLFOX6 chemotherapy and adjusting the dose of 5-Fu according to the AUC can effectively reduce the adverse reaction,and improve the therapeutic effect.