PK参数指导结直肠癌患者5-FU剂量给药剂量的价值

The value of PK parameters in guiding the dosage of 5-FU in patients with colorectal cancer

目的探讨药动学(PK)参数指导结直肠癌患者中5-氟尿嘧啶(5-FU)剂量给药剂量的价值。方法选取2018年4月至2020年7月黑龙江省佳木斯市中心医院进行化疗的中晚期结直肠癌患者118例,依据随机信封抽签原则将患者分为PK组与传统组,每组各59例。传统组给予基于体表面积的5-FU给药方案治疗,PK组给予基于PK参数的5-FU给药方案治疗,两组均治疗观察3个周期,记录患者预后情况。结果PK组与传统组第1个周期、2个周期、3个周期血药浓度间差异均有统计学意义,且PK组治疗后的5-FU血药浓度均低于传统组(P<0.05)。PK组治疗期间的毒副反应发生率为25.42%,低于传统组的62.71%(P<0.05)。治疗后PK组的总有效率为83.05%,高于传统组的49.15%(P<0.05)。两组治疗后的情感功能、大体健康情况、身体功能、认知功能、社会适应功能、角色功能等生活质量评分均高于治疗前(P<0.05),PK组高于传统组(P<0.05)。结论相对于传统参数指导给药剂量,PK参数指导结直肠癌患者5-FU剂量给药剂量对5-FU的血药浓度、毒副反应均起到降低的作用,进而提高结直肠的治疗效果,有利于患者正常生活的恢复。

Objective To explore the value of pharmacokinetics(PK)parameters in guiding the dosage of 5-fluorouracil(5-FU)in patients with colorectal cancer.Methods From April 2018 to July 2020,a total of 118 cases of patients with advanced colorectal cancer who were selected for chemotherapy in Jiamusi Central Hospital in Heilongjiang Province were divided into PK group and traditional group with 59 cases each groups accorded to the principle of random envelope drawing.The traditional group were treated with 5-FU dosage regimen based on body surface area,and the PK group were treated with 5-FU regimen based on PK parameters.Both groups were treated and observed for 3 cycles,and the patients′prognosis were recorded.Results There were significant differences in blood concentration between PK group and traditional group in the first cycle,second cycle and third cycle,and the blood concentration of 5-FU in PK group was lower than that in traditional group(P<0.05).The incidence of adverse reactions during treatment in PK group was 25.42%,which was lower than that(62.71%)in traditional group(P<0.05).After treatment,the total effective rate of PK group was 83.05%,which was higher than that(49.15%)of traditional group(P<0.05).The quality of life scores of the two groups after treatment,such as emotional function,general health,physical function,cognitive function,social adaptation function,and role function,were higher than those before treatment(P<0.05),and the PK group were higher than the traditional group(P<0.05).Conclusion Compared with the traditional parameter-guided dosage,dosage of 5-FU in patients with colorectal cancer guided by PK parameter can reduce the blood concentration and toxic and side effects of 5-FU,so as to improve the treatment effect of colorectal cancer and benefit the recovery of patients′normal life.