| 张中琴.胆管或胰腺癌并肝功能异常15例应用吉西他滨治疗的剂量选择[J].安徽医药,2019,23(1):152-154. |
| 胆管或胰腺癌并肝功能异常15例应用吉西他滨治疗的剂量选择 |
| The optimized dose of gemcitabine to treat biliary or pancreatic cancer withliver dysfunction in 15 cases |
| 投稿时间：2017-03-06 |
| DOI： |
| 中文关键词: 胆道肿瘤 胰腺肿瘤 吉西他滨 药物剂量计算 药代动力学 |
| 英文关键词: Biliary tract neoplasms Pancreatic neoplasms Gemcitabine Drug dosage calculations Pharmacokinetics |
| 基金项目: |
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| 中文摘要: |
| 目的 肝功能障碍时胆管或胰腺癌病人应用吉西他滨治疗的剂量标准。方法 20112015年间鹤壁市传染病医院收治的胆管或胰腺癌成人病人15例,分为3组,根据其肝功能损伤程度(轻、中、重),依血清胆红素和肝脏转氨酶进行评价。吉西他滨按800或1 000 mg/m2静脉用药1周1次共3周,间隔1周后进行下一周期治疗,共用药4个周期。第一周期中评价病人的不良事件,吉西他滨药物动力学及其无效代谢物,确定最佳初始剂量。结果 15例病人纳入研究。肝功能轻度异常1例,中度异常6例,重度异常8例。15例病人均行胆管引流并接受吉西他滨治疗。1例中度肝功能障碍病人发生3级胆管炎,其接受剂量为1 000 mg/m2。无其他病人发生严重的治疗相关事件。本组病人间吉西他滨的血浆浓度和氟尿嘧啶脱氧核苷的血浆浓度差异无统计学意义。结论 轻或中度肝功能异常的胆管或胰腺癌病人吉西他滨单药治疗初始剂量无需减量。 |
| 英文摘要: |
| Objective Gemcitabine is an important anticancer drug.The optimal dose of gemcitabine in liver dysfunction of patients was not determined.Methods The fifteen patients of bile duct or pancreatic cancer were divided into 3 groups according to the degree of liver function damage.Gemcitabine at a dose of 800 or 1 000 mg/m2 was given as an i.v.infusion once weekly for 3 weeks,and after 1 week of treatment was given next cycle,4 cycles in all.The patients were prospectively evaluated for adverse events during the first cycle,and the pharmacokinetics of Gemcitabine and its inactive metabolite,difluorodeoxyuridine,were studied to determine the optimal initial dose of Gemcitabine as monotherapy according to the severity of liver dysfunction.Results A total of 15 patients were studied.Liver dysfunction was mild in one patient,moderate in six and severe in eight.All 15 patients had been undergoing biliary drainage for obstructive jaundice when they received Gemcitabine.Grade 3 cholangitis developed in one patient with moderate liver dysfunction who received Gemcitabine at the dose level of 1000 mg/m2.No other patients had severe treatment-related adverse events resulting in the omission or discontinuation of Gemcitabine treatment.The plasma concentrations of gemcitabine and difluorodeoxyuridine were similar among the groups.Conclusions The initial dose of Gemcitabine monotherapy for patients with biliary or pancreatic cancer and mild or moderate hepatic dysfunction do not need reduce. |
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