摘要
目的探讨接受3周紫杉醇化疗方案的实体瘤患者紫杉醇血药浓度〉0.05μmol/L的时间（Tc〉0.05）与不良反应间的相关性。方法 200例实体瘤患者,均接受3周以紫杉醇为基础的化疗方案,于每周期化疗静脉滴注紫杉醇后18～30h采集外周血2～3mL,检测紫杉醇血药浓度并测定Tc〉0.05值,比较Tc〉0.05值≤35h者和Tc〉0.05值〉35h者不良反应发生情况,并基于Tc〉0.05的剂量调整模型进行剂量调整。结果 200例患者紫杉醇血药浓度为13～194μg/L,Tc〉0.05值为11～55h;Tc〉0.05值在性别、年龄、TNM分期上差异均无统计学意义（P〉0.05）;Tc〉0.05值〉35h组Ⅲ～Ⅳ级中性粒细胞减少发生率（87.5%）及血小板减少发生率（75.0%）明显高于Tc〉0.05值≤35h组（2.7%、4.3%）（P〈0.05）,Ⅲ～Ⅳ级胃肠道反应、神经毒性、肝功能损害发生率（12.5%、6.3%、18.8%）与Tc〉0.05值≤35h组（19.6%、1.6%、4.3%）比较差异无统计学意义（P〉0.05）。结论接受紫杉醇为基础的3周化疗方案的实体瘤患者紫杉醇Tc〉0.05与严重中性粒细胞减少及血小板减少明显相关,将Tc〉0.05控制在35h以下可减少血液学不良反应。
Objective To investigate the correlation between pharmacokinetic parameter paclitaxel Tc〉0.05 and adverse reactions in patients with solid tumors receiving 3-week paclitaxel chemotherapy. Methods Totally 200 patients with solid tumor receiving 3-week paclitaxel chemotherapy were collected 2 to 3 mL blood in 18 to 30 hours after intravenous infusion of paclitaxel and were detected paclitaxel concentration and Tc〉0.05. The incidences of adverse reactions were compared between ≤35 hours and 〉35 hours of Tc〉0.05 value, and paclitaxel doses were reduced based on chemotherapy-associated toxicity. Results Paclitaxel concentration in 200 patients was 13 to 194 μg/L and the value of Tc〉0.05 was from 11 to 55 hours. There were no significant differences in Tc〉0.05 values in the different genders, ages and TNM stages （P〉0.05）. The incidences of neutropenia of Ⅲ to Ⅳ grade （87.5%） and thrombocytopenia （75.0%） in 〉35 hours group were significantly higher than those in 435 hours group （2.7%, 4.3%） （P〈0.05）. The incidences of Ⅲ to Ⅳ grade gastrointestinal reactions, neurotoxicity and liver function damage in 〉35 hours group （12.5 %, 6.3 %, 18.8 %） showed no significant differences in comparison with those in 435 hours group （19.6%, 1.6%, 4.3%） （P〉0.05）. Conclusion The pharmacokinetic parameter paclitaxel Tc〉0.05 is obviously correlated with severe neutropenia and thrombocytopenia, and maintaining paclitaxe Tc〉0.05 within 35 hours could reduce hematological adverse reactions in patients receiving 3-week paclitaxel chemotherapy.
出处
《中华实用诊断与治疗杂志》
2016年第6期614-616,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
江苏省科技厅2015年社会发展项目(SBE2015740668)
南京市科技计划项目(201503006)
关键词
肿瘤
紫杉醇
血药浓度
药代动力学参数
药物不良反应
Tumour
paelitaxel
plasma concentration
pharmacokinetics parameter
adverse reaction
