核素肾动态显像对晚期胃癌FOLFOX4方案化疗后肾损害的评价

Evaluation of radionuclide renal dynamic imaging on the renal damage with FOLFOX4 chemtherapy on the advanced gastric cancer

目的:探讨核素肾动态显像在晚期胃癌患者FOLFOX4方案化疗后肾损伤评价中的作用。方法:对28例晚期胃癌患者首次化疗前和化疗3个周期后行^(99m)Tc-DTPA肾动态显像,测定肾小球滤过率(GFR)、高峰时间(Tb)、半排时间(C_(1/2))。同时检测血清肌酐(Scr)、尿素氮(BUN)水平。结果:28例患者中有27例GFR水平、肾清除^(99m)Tc-DTPA速度、肾功能曲线峰高峰时间化疗3个周期后较首次化疗前无明显变化,差异无统计学意义(P>0.05);1例患者在化疗后GFR水平较化疗前下降,肾功能曲线峰时延长,峰值减低,排泄段下降缓慢。化疗前后血清Scr水平及BUN水平比较无统计学差异。结论:5-FU联合奥沙利铂方案治疗晚期胃癌无明显肾脏毒性。^(99m)Tc-DTPA肾动态显像能够全面、定量的评价晚期胃癌化疗后肾损伤,为临床治疗方案及化疗药物的选择提供参考。

Objective：To explore the effect of radionuclide renal dynamic imaging on the renal damage after the chemotherapy of FOLFOX4 on patients with advanced gastricb cancer.Methods：Twenty-eight patients with advanced gastricb cancer received the radionuclide renal dynamic imaging of ^99mTc-DTPA before chemotherapy and three cycles chemotherapy and the patients were detected for GFR,Tb,C1/2,Scr and BUN.Results：There was no difference on the GFR,the renal clearance of ^99mTc-DTPA,renal function curve peak time in twenty seven patients after three cycles of chemotherapy comparing with before intial chemotherapy（P〉0.05）.There was one patient who had decreased in GFR and prolonged the renal function curve peak time and reduced the peak and declined slowly in excretion segment.There was no difference in serum Scr before and after chemotherapy.Conclusion：There is no significant renal toxicity of 5-FU combined with oxaliplatin for the patients with advanced gastricb cancer.The radionuclide renal dynamic imaging of ^99mTc-DTPA can evaluate the renal damage of patients with advanced gastricb cancer after the chemotherapy comprehensively and quantitatively and can provide the reference for the choice of clinical treatment and chemotherapy drugs.