晚期结直肠癌患者5-FU药代动力学参数AUC与不良反应及近期疗效的相关性分析

发布时间：2017-12-28 06:03

本文关键词：晚期结直肠癌患者5-FU药代动力学参数AUC与不良反应及近期疗效的相关性分析　出处：《郑州大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:检测接受mFOLFOX6[奥沙利铂+亚叶酸钙+5-氟尿嘧啶(5-Fluorouracil,5-FU)]方案化疗晚期结直肠癌患者5-FU的药代动力学参数AUC,分析AUC与化疗产生的不良反应与治疗效果的相关性,为临床个体化治疗提供理论基础。方法:选自2014年5月—2015年5月郑州大学人民医院肿瘤科住院的晚期结直肠癌患者62例,接受标准mFOLFOX6(奥沙利铂+亚叶酸钙+5-FU)方案化疗,2周为1个周期,于化疗第1周期5-FU静脉滴注18~30 h内采集外周静脉血并测定血药浓度,计算AUC,化疗2个周期后评价治疗效果和不良反应。分析AUC≤25(mg·h)/L、25(mg·h)/L组不良反应发生情况;比较AUC≤20(mg·h)/L和AUC20(mg·h)/L组疗效差异。结果:1.62例结直肠癌患者5-FU药代动力学参数AUC呈正态分布,为5.2~39.1(mg·h)/L,均值为21.26(mg·h)/L,中位值为22.20(mg·h)/L,其中AUC25(mg·h)/L者25例,20~25(mg·h)/L者12例,≤20(mg·h)/L者25例。2.AUC≤25(mg·h)/L组Ⅲ~Ⅳ级骨髓抑制、腹泻、黏膜炎发生率(11%、5%、8%)低于25(mg·h)/L组(44%、28%、32%),差异有统计学意义(P0.05)。3.AUC≤20(mg·h)/L组总体反应率(32.0%)低于AUC20(mg·h)/L组(59.5%),差异有统计学意义(P0.05)。结论:接受mFOLFOX6方案化疗的晚期结直肠癌患者,5-FU药代动力学参数AUC在20~25(mg·h)/L可获得最佳近期疗效,最轻不良反应。
[Abstract]:Objective: to detect the mFOLFOX6[oxaliplatin + calcium folinate +5- fluorouracil (5-Fluorouracil, 5-FU) pharmacokinetic parameters AUC] chemotherapy in advanced colorectal cancer patients 5-FU, correlation analysis between AUC and chemotherapy adverse reaction and curative effect, provide a theoretical basis for clinical individualized treatment. Methods: from May 2014 to May 2015 the people's Hospital of Zhengzhou University, Department of oncology advanced colon 62 cases of rectal cancer patients receiving standard mFOLFOX6 (oxaliplatin + calcium folinate +5-FU) chemotherapy, 2 weeks for 1 cycles, first cycles of chemotherapy with intravenous infusion of 5-FU 18~30 h in venous blood and determination of blood concentration, calculation AUC, the treatment effect and adverse reaction were evaluated after 2 cycles of chemotherapy. Analysis of AUC = 25 (Mg - H), 25 /L (Mg - H) the incidence of adverse reactions in group /L; AUC = 20 (Mg - H) /L and AUC20 (Mg, H) the difference effect of /L group. Results: 1.62 cases of colorectal cancer patients with 5-FU pharmacokinetic parameters AUC normal distribution, 5.2~39.1 (mg h /L), the mean of 21.26 (Mg, H) /L, the median was 22.20 (Mg, H) /L, AUC25 (Mg - H) and 25 cases of /L, 20~25 (mg. H) 12 /L cases, 20 (mg = h) and 25 cases of /L. 2.AUC = 25 (Mg - H) the incidence of /L group III ~ IV myelosuppression, diarrhea, mucositis (11%, 5%, 8%) less than 25 (Mg - H) /L group (44%, 28%, 32%), the difference was statistically significant (P0.05). 3.AUC = 20 (Mg - H) /L group, the overall response rate (32%) than AUC20 (Mg - H) /L group (59.5%), the difference was statistically significant (P0.05). Conclusion: for patients with advanced colorectal cancer receiving mFOLFOX6 chemotherapy, the 5-FU pharmacokinetic parameter AUC has the best short-term efficacy and the least adverse reaction in 20~25 (mg. H) /L.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.34

【相似文献】