【摘要】 目的:研究顺铂用于非小细胞肺癌化疗的疗效、毒性与时间的关联性。方法:16名非小细胞肺癌化疗患者使用顺铂联合长春瑞滨方案治疗,静脉滴注给药,采用2种用药方案,分别为顺铂20mg·m-2,d1～5+长春瑞滨25mg·m-2,d1、8和顺铂60mg·m-2,d1、2+长春瑞滨25mg·m-2,d1、8。动态采集患者0～96h血液样本,采用高效液相色谱法测定给药后顺铂血药浓度,按世界卫生组织制定的疗效和毒副反应分级标准评价疗效和药品不良反应,将其按疗效和毒性反应进行分组(疗效:完全缓解+部分缓解(CR+PR)组和稳定+无效(SD+PD)组;消化道反应:0～Ⅱ度组和Ⅲ～Ⅳ度组;骨髓抑制:白细胞(WBC)减少组和WBC未减少组),分别比较2组之间不同时间点血药浓度的差异,观察其P值随时间的变化。结果:疗效、消化道反应及骨髓抑制比较,2组间P值随时间的变化均呈两端小、中间大的变化。结论:顺铂用于非小细胞肺癌化疗后0～96h,靠近0及96h两端时间点的血药浓度更能反映其疗效及毒性的变化,在所取时间点中,0.25h为最佳取血点。更多还原

【Abstract】 OBJECTIVE:To study the correlation of therapeutic efficacy,toxicity and time of cisplatin for non-small cell lung cancer(NSCLC).METHODS:Cisplatin(DDP) and vinorelbine(NVB) was administered in 16 patients with NSCLC by intravenous drip infusion.16 patients with NSCLC were given cisplatin and vinorelbine in different administration(DDP 60 mg·m-2 d1～2,NVB 25 mg·m-2 d 1 and d 8 or DDP 20 mg·m-2 d1～5,NVB 25 mg·m-2 d 1 and d 8).Blood samples of 0～96 hours were collected.HPLC was used to determine plasma concentration of cisplatin.The curative effect and adverse drug reactions were evaluated according to the standard of WHO and toxicity evaluation criteria.Blood samples were divided into different groups according to curative effect and toxicity(curative effect:CR+PR group and SD+PD group;reaction of digestive tract:0～Ⅱdegree group and Ⅲ～Ⅳ degree group;bone marrow depression:eukopenia group and non-leukopenia group).The differences of plasma concentrations at different time points were compared among those groups.The change of P value was observed.RESULTS:In the groups of curative effect,reaction of digestive tract and bone marrow depression,we found that the change of P value was small in both sides and big in middle.CONCLUSION:0～96 hours after chemotherapy of cisplatin,the times of both sides reflect curative effect and toxicity effectively.更多还原