【摘要】 目的:探讨结直肠癌患者行FOLFOX6方案化疗后5-氟尿嘧啶(5-FU)稳态血药浓度(Css)与疗效及不良反应的相关性和临床意义。方法:收集接受FOLFOX6方案化疗的晚期结直肠癌患者共48例,采用高效液相色谱(HPLC)法检测结直肠癌患者外周血5-FUCss,分析5-FUCss与不良反应、缓解率的关系。结果:5-FUCss在48例结直肠癌患者中不呈正态分布,范围153.7～1094.8μg/L,平均(400.0±190.2)μg/L,个体之间变异较大。随着结直肠癌患者Css的升高,骨髓抑制、口腔黏膜炎及腹泻等不良反应的发生率明显增加,P<0.05。化疗有效患者的平均Css为(469.9±210.8)μg/L,明显高于疾病稳定和进展的患者〔(384.4±127.1)和(257.9±104.2)μg/L〕,P<0.05。结论:结直肠癌患者化疗时Css在300～600μg/L时将获得最佳的疗效和最小的不良反应。更多还原

【Abstract】 OBJECTIVE:To explore the significance of 5-FU Concentration at steady state (Css) in colorectal cancer patients after received FOLFOX6 regimen and its correlation with response rate and toxicities.METHODS:A total of 48 colorectal cancer patients were collected and treated with FOLFOX6 regimen.Peripheral serum concentration of 5-FU at steady state were detected by high performance liquid chromatography methods(HPLC)after the patients received FOLFOX6 regimen.Then relationship of Css of 5-FU with toxicities and response rate were analysed.RESULTS:Css of 5-FU in 48 colorectal cancer patients were abnormal distribution and ranged from 153.7 to 1 094.8 μg/L,with the mean level of (400.0±190.2) μg/L,which showed great variation among the patients.Incidence of myelotoxicity,mucoxitis and diarrhea increased with Css of 5-FU and showed significant difference (P<0.05).The average Css of 5-FU in patients responsed to chemotherapy was (469.9±210.8) μg/L,which was much higher than those patients with stable diseases or progressive diseases:(384.4±127.1) μg/L and (257.9±104.2) μg/L,and with significant difference (P<0.05).CONCLUSION:When Css of 5-FU ranged from 300-600 μg/L,colorectal cancer patients will obtain optimal response rate and less toxicities.更多还原