治疗药物监测在晚期食管癌多西他赛联合奈达铂化疗中的应用价值
发布时间：2018-11-15 11:29
【摘要】：目的多西他赛广泛应用于多种癌症治疗,但由于其个体药代动力学差异较大和治疗窗狭窄,个体间疗效和不良反应差异较大。本研究探讨晚期食管癌患者应用多西他赛联合奈达铂方案化疗过程中,进行治疗药物监测的意义。方法收集2014-07-01-2015-12-31南通大学附属肿瘤医院晚期食管癌患者72例,给予多西他赛75mg/m2,静脉滴入d1;奈达铂80mg/m2,静脉滴入d1,21d为1个周期。多西他赛静脉滴入结束前10min和静脉滴入结束后30~60min各采集静脉2mL,采用胶乳免疫比浊法检测血药浓度,对血药浓度结果进行药代动力学分析,得出血药浓度-时间曲线下面积(area under concentration-time curve,AUC)。根据多西他赛AUC值,分为高AUC组、正常范围AUC组和低AUC组。比较3组近期疗效,每2个周期结束评价近期疗效,并观察不良反应发生情况。结果 3组有效率、临床获益率差异均无统计学意义,P0.05。低AUC组Ⅲ+Ⅳ级白细胞减少发生率为11.76%,低于正常范围AUC组的42.86%,P=0.033;高AUC组Ⅲ+Ⅳ级血小板减少发生率为61.54%,明显高于正常范围AUC组23.81%,P=0.020。较正常范围AUC组贫血发生率52.27%,高AUC组贫血发生率(92.31%)明显升高,P=0.015。而恶心呕吐、口腔炎和体液潴留等不良反应发生率比较差异无统计学意义,P0.05。结论多西他赛药代动力学参数AUC与晚期食管癌患者多西他赛联合奈达铂化疗所致血液学毒性严重程度密切相关,进行治疗药物监测值得在临床推广和应用。
[Abstract]:Objective docetaxel is widely used in the treatment of many kinds of cancer, but because of the difference of pharmacokinetics and narrow therapeutic window, there are great differences in efficacy and adverse reactions among individuals. The purpose of this study was to investigate the significance of drug monitoring in patients with advanced esophageal cancer treated with docetaxel combined with nedaplatin regimen. Methods Seventy-two patients with advanced esophageal cancer were treated with docetaxel 75mg / m2, intravenous drip of d1and neitabine 80mg / m2, d1a 21d, respectively, in the cancer hospital affiliated to Nantong University, 2014-07-01-2015-12-31. Before and after intravenous infusion of docetaxel, 10min and 30~60min were collected for 2 mL respectively. The serum concentration was detected by latex immunoturbidimetry, and the results of pharmacokinetics were analyzed. The area under the bleeding concentration-time curve (area under concentration-time curve,AUC) was obtained. According to the AUC value of docetaxel, they were divided into high AUC group, normal range AUC group and low AUC group. The short-term curative effect of 3 groups was compared, the short-term curative effect was evaluated at the end of every 2 cycles, and the occurrence of adverse reaction was observed. Results there was no significant difference in effective rate and clinical benefit rate among the three groups (P 0.05). The incidence of grade 鈪，
本文编号：2333186
[Abstract]:Objective docetaxel is widely used in the treatment of many kinds of cancer, but because of the difference of pharmacokinetics and narrow therapeutic window, there are great differences in efficacy and adverse reactions among individuals. The purpose of this study was to investigate the significance of drug monitoring in patients with advanced esophageal cancer treated with docetaxel combined with nedaplatin regimen. Methods Seventy-two patients with advanced esophageal cancer were treated with docetaxel 75mg / m2, intravenous drip of d1and neitabine 80mg / m2, d1a 21d, respectively, in the cancer hospital affiliated to Nantong University, 2014-07-01-2015-12-31. Before and after intravenous infusion of docetaxel, 10min and 30~60min were collected for 2 mL respectively. The serum concentration was detected by latex immunoturbidimetry, and the results of pharmacokinetics were analyzed. The area under the bleeding concentration-time curve (area under concentration-time curve,AUC) was obtained. According to the AUC value of docetaxel, they were divided into high AUC group, normal range AUC group and low AUC group. The short-term curative effect of 3 groups was compared, the short-term curative effect was evaluated at the end of every 2 cycles, and the occurrence of adverse reaction was observed. Results there was no significant difference in effective rate and clinical benefit rate among the three groups (P 0.05). The incidence of grade 鈪，
本文编号：2333186
本文链接：https://www.wllwen.com/yixuelunwen/zlx/2333186.html
