Clinical Value of Pharmacokinetic Monitoring of Serum Paclitaxel Concentration in Paclitaxel-based Chemotherapy on Patients with Ovarian Cancer
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摘要:目的
研究卵巢癌患者化疗后，紫杉醇（PTX）血药浓度与疗效及不良反应的相关性。
方法75例卵巢癌患者接受PT方案（紫杉醇+卡铂）一线化疗。于每周期PTX静脉输注开始后（24±6）h采集静脉血2次，采用胶乳免疫比浊法检测PTX浓度。根据PTX血药浓度的平均值，将75例患者分为≤25 h组、（26~30）h组和≥31 h组，回顾性分析PTX血药浓度与疗效及与不良反应间的相关性。
结果≤25 h组、（26~30）h组、≥31 h组PTX血药浓度分别为（22.54±2.04）h、（28.62±1.87）h、（33.01±2.84）h，差异有统计学意义（P < 0.05）。随着PTX血药浓度的升高，化疗的不良反应发生率增多，程度加强（P < 0.05）。（26~30）h组的有效率（31.25%）高于≤25 h组（20%）（P=0.02），与≥31 h组有效率（33.33%）相比差异无统计学意义（P=0.96）。
结论卵巢癌采用紫杉醇PTX血药浓度在（26~30）h的患者疗效好，且不良反应稍低。
Abstract:ObjectiveTo investigate the relationship between plasma concentration of paclitaxel (PTX) and the efficacy as well as toxic and side effects in the patients with ovarian cancer.
MethodsSeventy-five patients with ovarian cancer accepted PT (paclitaxel+carboplatin) chemotherapy regimen as their first line treatment. The blood samples were taken twice at (24±6) h after continuous infusion of paclitaxel in each cycle and the plasma concentration of paclitaxel was detected by latex immuno-turdidimetry. The patients were randomly assigned into three groups according to the average plasma concentration of paclitaxel: group 1 (plasma concentration paclitaxel≤25h), group 2(26-30h) and group 3(≥31h). The relationship between the drug plasma concentration, therapeutic efficacy and adverse reactions in different paclitaxel plasma concentration was analyzed retrospectively.
ResultsThe average plasma concentrations of paclitaxel of the three groups were (22.54±2.04) h, (28.62±1.87) h, 33.01±2.84) h, respectively (P < 0.05). The incidence and extent of adverse reactions were significantly higher and stronger with the increasing plasma concentration of paclitaxel. The therapeutic efficacy of group 2 (26-30) h was 31.25% which was better than that (20%) of group 1 (≤25h) (P=0.02), but had no significant difference with that (33.33%) of group 3 (≥31h) (P=0.96).
ConclusionThe ovarian cancer patients treated with paclitaxel-based chemotherapy with an average plasma concentration of paclitaxel between 26-30h have a higher curative effect and lower toxic side effect.
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Key words:
- Ovarian cancer /
- Paclitaxel /
- Plasma concentration /
- Latex immuno-turdidimetry
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图 2 基于BSA给药的不同患者PTX血药浓度（Tc > 0.05）的分布
Figure 2 The distribution of PTX blood concentration (Tc > 0.05) in different patients based on BSA administration
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图 3 基于BSA给药的卵巢癌患者PTX浓度与白细胞减少的相关性
Figure 3 The correlation between PTX concentration and leukopenia in ovarian cancer patients based on BSA administration
表 1 患者各时间点药物浓度
Table 1 Concentration of PTX in patients' blood (μmol/L) at different timepoints
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表 2 不同患者紫杉醇临界0.05 μmol/L血药浓度以上暴露时间
Table 2 Exposure time of blood concentration above 0.05μmol/L in different patients
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表 3 不同PTX血药浓度的卵巢癌患者的临床特征比较
Table 3 The clinical features of ovarian cancer patients with different PTX concentration
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表 4 三组不同PTX血药浓度患者的不良反应比较 (n)
Table 4 The toxic side effect in three patients' groups with different PTX concentrations (n)
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表 5 三组不同PTX浓度患者的疗效比较 (n)
Table 5 The curative effect in three patients' groups with different PTX concentrations (n)
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