The relationship between the dose of fluorouracil and its plasma concentration and the survival of patients with advanced colorectal cancer / 肿瘤

ABSTRACT

Objective: To investigate the relationship between 5-FU (5-fluorouracil) dose (based on body surface area or not) and its plasma concentration and the overall survival of patients with advanced colorectal cancer receiving 5-FU-based chemotherapy regimens as standard first- and second-line treatment. Methods: One hundred and ninety-two patients with advanced colorectal cancer received 5-FU-based chemotherapy regimens of FOLFOX (5-FU, calcium folinate and oxaliplatin) and FOLFIRI (5-FU, calcium folinate and irinotecan ) as first-line and second-line chemotherapy, respectively or in a reverse sequence. Plasma concentration of 5-FU at steady state was examined when the dose of 5-FU was adjusted according to the toxicity in each patient. Results: The plasma concentration of 5-FU was not associated with the dose of continuous infusion of 5-FU (r = 0.066, P = 0.146), and also not associated with the dose of infusional 5-FU based on body surface area (r = 0.056, P = 0.217). Median overall survival was 31.4 months for patients with high plasma concentration of 5-FU (> 30 μg/L) versus 14.5 months for patients with low plasma concentration of 5-FU (< 30 μg/L) (P = 0.001). The adverse effects including grades 3-4 neutropenia and hand foot syndrome were more frequent in patients with high plasma concentration of 5-FU. Conclusion: The monitoring of plasma concentration of 5-FU may be a basis for dose adjustment of 5-FU in safe and effective range for patients with advanced colorectal cancer. Copyright © 2013 by TUMOR.