| PurposeToday,Docetaxel(DTX),like most chemotherapeutic drugs,is administered according to Body Surface Area(BSA).Due to the pharmacological differences between the individual patients,the AUC gap can be up to 7 times and the overall clearance rate can be up to 10 times.A large number of clinical data have confirmed that the pharmacological differences between individuals and themselves are the main cause of excessive toxicity or even treatment failure of chemotherapy drugs [2].The factors causing this pharmacological difference mainly include the patient’s own factors such as gene composition,physiological state,and genetic characterization,and other external factors [6-7].A large number of literatures indicate that there is a lack of statistical correlation between the exposure of patients with BSA and docetaxel [ 7-9].To reduce this situation from happening,we will use a fully automated biochemical analyzer and Mycare docetaxel kit to monitor the plasma concentration of patients with ovarian cancer using docetaxel and calculate the pharmacokinetics in mg·h/L.Area under Concentration-tine Curve(AUC),and further explore the relationship between AUC and BSA,BMI,absolute dose,AUC difference between different individuals and AUC and toxic side effects.MethodsA total of 83 patients with ovarian cancer were included in the analysis(from the First Affiliated Hospital of Zhengzhou University in 2016-2017),receiving "Docetaxel + Nidaplatin" chemotherapy,and a chemotherapy cycle of 3 weeks.We monitor the blood concentration of each patient during each preiod after using the method of body surface.There are two blood samples to be collected: monitoring blood sample 1: 0-10 minutes before the end of DTX infusion;monitoring blood sample 2: collecting within 30-60 minutes after the end of DTX infusion.The concentration of the bleeding agent was measured by an automatic biochemical analyzer,and the AUC value was calculated by the Mycare DTX kit.The side effects of chemotherapy were evaluated on the third day after chemotherapy,and the relationship between AUC and BSA,age,dose,toxicity and side effects,and the difference in AUC between different individuals were analyzed using statistical software.ResultsAmong the 83 patients,42 patients had leukaemia,32 patients had neutropenia,44 patients had hemoglobin reduction,and 64 had thrombocytopenia.The incidence rates were 50.60%,38.6%,53.0%,and 77.1% respectively.The statistical software SPSS 21.0 was used at this condition.Spearman correlation analysis found that the correlation coefficient between the AUC of hematological toxicity and the corresponding white blood cell value,neutrophil value,hemoglobin value and platelet value after chemotherapy was-0.095,-0.09,-0.109,-0.079 respectively.Negative correlation indicates that the greater the AUC value,the lower the white blood cell value,neutrophil value,hemoglobin value and platelet value after chemotherapy.In the case of α=0.05,the hypothesis test excludes the possibility that the correlation coefficient is equal to 0,so the correlation coefficient r is statistically significant。The pharmacological parameters of docetaxel in 83 cases ranged from 1.1 to 5.4,the mean was 2.489,the standard deviation was 0.7896,the coefficient of variation between individuals was 31.72%,and the blood concentration parameter AUC of 42 cycles of hemotoxicity occurred.The range is 1.4-5.4,the mean is 2.493,and the standard deviation is 0.8432.The lower limit of the reference range of AUC for hemotoxicity in 95% of patients is 1.430 and the upper limit is 4.765.According to statistical software analysis,the correlation coefficients between body surface area,age,dose and AUC were r=0.140,P=0.104,r=0.023,p=0.417,r=0.015,p=0.447.If we do this analysis according to α=0.05,the hypothesis test can not rule out the possibility that the correlation coefficient is equal to 0,and there is no linear correlation between body surface area,age,dose and AUC value.ConclusionThe pharmacological parameters of DTX differ greatly among individuals,and it needs to be improved according to the mode of BSA administration;the dose of the next chemotherapy can be guided according to the AUC value at the end of the chemotherapy;the AUC of hematological toxicity and the white blood cell value after chemotherapy,the neutrophil value,hemoglobin value and platelet value were negatively correlated,indicating that the greater the AUC value,the lower the white blood cell value,hemoglobin value and platelet value after chemotherapy,the more likely the patient will have hematological toxicity;the toxicity reference range of the pharmacological parameters AUC of docetaxel was 1.430—4.765;there was no statistically significant correlation between body surface area,age,dose and AUC. |
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