Tailored chemotherapy to equal toxicity: is it possible?
Tailored chemotherapy to equal toxicity: is it possible?
复制标题
定制化疗以达到同等毒性：可能吗？
DOI：
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发表时间：
1998
期刊：
影响因子：
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通讯作者：
J. Bergh
中科院分区：
文献类型：
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作者：
J. Bergh
在器官功能正常的患者中，基于体表面积的常规化疗剂量将导致所用细胞抑制剂全身暴露的显著个体间差异。这将导致与不必要的毒性和次优结局相关的个体患者的过度治疗和治疗不足。修改剂量的意图是出于毒性和结果之间可能的相关性。应研究个体定制治疗的新剂量策略，目的是增加治疗的疗效而不增加其毒性。使用有限采样程序的药代动力学监测可能是一种替代方法，另一种毒性指导剂量。基于等效血液学毒性的治疗，用于定制FEC综合化疗（6个剂量水平）的剂量方案在临床上适用于多中心辅助和术前治疗。在辅助治疗中，它导致了显著更高的表阿霉素和环磷酰胺剂量的输送，而没有增加相同程度的急性毒性;在三分之二的患者中，与较低剂量水平相比，最高两个剂量水平的急性毒性没有差异。简而言之，如果我们更好地使用现有的细胞抑制剂，我们可以获得更好的结果。
Conventional dosage of chemotherapy based on body surface area in patients with normal organ functions will result in marked interindividual variations in systemic exposure to the cytostatics used. This will result in over- and undertreatment of the individual patient associated with unwarranted toxicity and suboptimal outcome. The intention to modify dosage is motivated by a possible correlation between toxicity and outcome. New dosage strategies with individual tailoring of the therapy should be investigated with the aim of increasing the efficacy of therapy without increasing its toxicity. Pharmacokinetic monitoring using the limited sampling procedure could be one alternative, another toxicity-guided dosage. The dosage scheme used for tailored FEC polychemotherapy (six dose levels), based on therapy to equivalent haematological toxicity, has been clinically applicable in the multicentre setting for both adjuvant and preoperative therapy. In the adjuvant setting it has resulted in the delivery of significantly higher epirubicin and cyclophosphamide doses without increasing acute toxicity to the same extent; in two out of three patients no difference in acute toxicity could be verified for the highest two dose levels compared with the lower dose levels. In short, we could obtain better results with our present arsenal of cytostatics if we used them better.
根据体重或体表面积进行剂量标准化对成人有用吗？
DOI：
10.1093/jnci/82.4.323
发表时间：
1990
期刊：
Journal of the National Cancer Institute
影响因子：
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作者：
Grochow,LB;Baraldi,C;Noe,D
通讯作者：
Noe,D