【摘要】：目的多西他賽廣泛應(yīng)用于多種癌癥治療,但由于其個(gè)體藥代動(dòng)力學(xué)差異較大和治療窗狹窄,個(gè)體間療效和不良反應(yīng)差異較大。本研究探討晚期食管癌患者應(yīng)用多西他賽聯(lián)合奈達(dá)鉑方案化療過(guò)程中,進(jìn)行治療藥物監(jiān)測(cè)的意義。方法收集2014-07-01-2015-12-31南通大學(xué)附屬腫瘤醫(yī)院晚期食管癌患者72例,給予多西他賽75mg/m2,靜脈滴入d1;奈達(dá)鉑80mg/m2,靜脈滴入d1,21d為1個(gè)周期。多西他賽靜脈滴入結(jié)束前10min和靜脈滴入結(jié)束后30~60min各采集靜脈2mL,采用膠乳免疫比濁法檢測(cè)血藥濃度,對(duì)血藥濃度結(jié)果進(jìn)行藥代動(dòng)力學(xué)分析,得出血藥濃度-時(shí)間曲線(xiàn)下面積(area under concentration-time curve,AUC)。根據(jù)多西他賽AUC值,分為高AUC組、正常范圍AUC組和低AUC組。比較3組近期療效,每2個(gè)周期結(jié)束評(píng)價(jià)近期療效,并觀察不良反應(yīng)發(fā)生情況。結(jié)果 3組有效率、臨床獲益率差異均無(wú)統(tǒng)計(jì)學(xué)意義,P0.05。低AUC組Ⅲ+Ⅳ級(jí)白細(xì)胞減少發(fā)生率為11.76%,低于正常范圍AUC組的42.86%,P=0.033;高AUC組Ⅲ+Ⅳ級(jí)血小板減少發(fā)生率為61.54%,明顯高于正常范圍AUC組23.81%,P=0.020。較正常范圍AUC組貧血發(fā)生率52.27%,高AUC組貧血發(fā)生率(92.31%)明顯升高,P=0.015。而惡心嘔吐、口腔炎和體液潴留等不良反應(yīng)發(fā)生率比較差異無(wú)統(tǒng)計(jì)學(xué)意義,P0.05。結(jié)論多西他賽藥代動(dòng)力學(xué)參數(shù)AUC與晚期食管癌患者多西他賽聯(lián)合奈達(dá)鉑化療所致血液學(xué)毒性嚴(yán)重程度密切相關(guān),進(jìn)行治療藥物監(jiān)測(cè)值得在臨床推廣和應(yīng)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，

本文編號(hào)：2333186