基于不同剂量5-FU化疗对晚期结直肠癌患者的影响

Effects of Chemotherapy Based on Different 5-FU Doses on Patients with Advanced Colorectal Cancer

目的探讨基于不同剂量5-氟尿嘧啶(5-FU)化疗对晚期结直肠癌患者的影响。方法选取2015年2月-2018年7月于我院接受化疗的晚期结直肠癌患者120例为研究对象,根据随机数字表法分为观察组和对照组,各60例。对照组采用基于传统体表面积的5-FU给药方案治疗,观察组采用基于药代动力学参数的5-FU给药方案治疗。两组均同时配合常规联合用药,共治疗4个周期,观察并记录患者的预后情况。结果观察组第1、2、4个治疗周期的5-FU血药浓度均显著低于对照组(P<0.05)。观察组治疗总有效率(83.3%)显著高于对照组(50.0%)(P<0.05)。观察组患者治疗期间毒副反应(消化道、神经毒性、皮肤、血液系统)的发生率均显著低于对照组(P<0.05),且均可耐受,未出现治疗相关性死亡病例。随访至2019年10月,观察组患者的中位生存时间显著长于对照组(P<0.05)。结论相对于传统给药方案,采用基于药代动力学参数的5-FU给药方案可显著降低晚期结直肠癌患者的血药浓度,减少毒副反应的发生,提高患者的治疗效果并延长其生存时间。

Objective To investigate the effects of different doses of 5-fluorouracil(5-FU)chemotherapy on patients with advanced colorectal cancer.Methods A total of 120 patients with advanced colorectal cancer who underwent chemotherapy in our hospital between Febrnary 2015 and July 2018 were selected in this study.They were divided into obsenvation group(n=60)and control group(n=60)according to the random number table.The dose of 5-FU for the control group was traditionally based on body surface area,and that for the observation group was based on pharmacokinetic parameters.Meanwhile,all were treated with conventional combination therapy.The two groups were treated for four cycles,and the prognosis of the patients were recorded and compared.Results The 5-FU plasma concentrations in the first,second,and fourth cycle of the obsenvation group all were significantly lower than those of the control group(P<0.05).After treatment,the total effective rate of the observation group(83.3%)were significantly higher than that of the control group(50.0%)(P<0.05).The incidences of toxic and side effects(on digestive tract reaction,neurotoxicity,skin reaction,blood system reaction)during the treatment cycles were significantly lower in observation group than in control group(P<0.05).All the side effects were tolerated,and no treatmentrelated death.During the followed-up period up to October 2019,the median survival time of the observation group were significantly longer than that of the control group(P<0.05).Conclusion The application of 5-FU dose based on pharmacokinetic parameters in chemotherapy for patients with advanced colorectal cancer could lower the plasma concentration of 5-FU,and reduce the occurrence of adverse reactions.It could also improve the treatment efficacy and prolong the survival time of patients.