氟尿嘧啶血药浓度监测在进一步提高晚期胃癌化疗疗效及减少不良反应预测中的作用

Role of Fluorouracil Blood Concentration Monitoring in Further Improving Chemotherapy Efficacy and Reducing Adverse Reaction Prediction of Advanced Gastric Cancer

摘要: 目的：探讨氟尿嘧啶血药浓度监测在进一步提高晚期胃癌化疗疗效及减少不良反应预测中的作用。方法：选择某院2015年1月~2017年1月接受DCF化疗方案(多西他赛 + 顺铂 + 氟尿嘧啶)的晚期胃癌患者90例作为研究对象，依据随机数字表法将患者分为对照组、观察组各45例，对照组根据体表面积计算化疗药物给药剂量，观察组在第1个化疗周期同对照组，第2个化疗周期至化疗结束均根据前1个化疗周期氟尿嘧啶血药浓度监测结果调整给药剂量，比较两组的近期疗效、癌因性症状评分、血清肿瘤标志物水平、不良反应发生率、远期生存情况、生存质量评分。结果：疾病控制率观察组为71.11%，高于对照组的48.89% (P < 0.05)。两组的癌因性疼痛、癌因性疲乏评分，血清CEA、CA125、CA199水平在治疗后均较治疗前降低(P < 0.05)，而且观察组较对照组更低(P < 0.05)。恶心呕吐、腹泻、骨髓抑制、黏膜炎等不良反应发生率在观察组中均低于对照组(P < 0.05)。观察组的1年存活率、2年存活率，存活患者随访1年、2年时的生存质量评分均较对照组增高(P < 0.05)。结论：氟尿嘧啶血药浓度监测对晚期胃癌患者的化疗具有良好的指导作用，可提高化疗疗效，减少化疗不良反应，有利于改善远期预后。

Abstract: Objective: To explore the role of fluorouracil blood concentration monitoring in further improving chemotherapy efficacy of advanced gastric cancer and reducing adverse reactions prediction. Methods: Choose a hospital from January 2015 to January 2017 to accept the DCF model chemotherapy (docetaxel + cisplatin + fluorouracil) of 90 patients with advanced gastric cancer as the research object, according to random number table method to divide the patients into control group and observation group 45 cases, control group according to body surface area calculation chemotherapy drugs to dose, observation group in the first cycle of chemotherapy with the control group, from the second cycle of chemotherapy to the end of chemotherapy, the dose was adjusted according to the monitoring results of serum fluorouracil concentration in the first cycle of chemotherapy, and the short- term efficacy, score of oncogenic symptoms, level of serum tumor markers, incidence of adverse reactions, long-term survival, and quality of life score of the two groups were compared. Results: The disease control rate in observation group was 71.11%, which was higher than 48.89% in control group (P < 0.05). The scores of cancer-induced pain, cancer-induced fatigue, and serum CEA, CA125 and CA199 levels in both groups were lower after treatment than before (P < 0.05), and lower in observation group than in control group (P < 0.05). The incidence of adverse reactions such as nausea and vomiting, diarrhea, myelosuppression and mucositis in the observation group was lower than that in the control group (P < 0.05). The 1-year survival rate and 2-year survival rate of the observation group and the quality of life score of the surviving patients after 1-year and 2-year follow-up were higher than those of the control group (P < 0.05). Conclusion: Monitoring the blood concentration of fluorouracil has a good guiding effect on chemotherapy for patients with advanced gastric cancer. It can improve the curative effect of chemotherapy, reduce adverse reactions of chemotherapy, and is conducive to improving long-term prognosis.