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高剂量表阿霉素在肿瘤患者中的药物动力学和药效学研究

董梅, 冯奉仪*, 付强, 朱珠   

  1. 1. 中国医学科学院中国协和医科大学肿瘤医院内科, 北京 100021;
    2. 中国医学科学院中国协和医科大学北京协和医院药剂科, 北京 100730
  • 收稿日期:1999-09-17 修回日期:2000-01-13 出版日期:2000-06-15 发布日期:2000-06-15
  • 通讯作者: 冯奉仪*

Study on Pharmacokinetics and Pharmacodynamics of High Dose Epirubicin in Cancer Patients

Dong Mei, Feng Fengyi*, Fu Qiang, Zhu Zhu   

  1. 1. Department of Medical Oncology Cancer Hospital Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 1000211;
    2. Department of Pharmacy Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730
  • Received:1999-09-17 Revised:2000-01-13 Online:2000-06-15 Published:2000-06-15
  • Contact: Feng Fengyi*

摘要: 目的: 研究高剂量表阿霉素在肿瘤化疗患者体内的药物动力学过程,并初步探讨药效学特点。方法: 11例肿瘤患者接受了包含100 mg·m-2高剂量表阿霉素的联合化疗, HPLC法测定血药浓度; PCNONLIN程序进行药物动力学房室模型数据拟合和参数计算; 血液学毒性指标作为药效学参数,进行药物动力学和药效学相关性及剂量调整因素的研究。结果: 高剂量表阿霉素的消除具有典型的三室特征,患者对表阿霉素的代谢存在较大的个体差异; 药效学和药物动力学参数之间未见到明显相关性,年龄与血浆清除率之间呈负相关。结论: 与低剂量表阿霉素比较,未发现药物动力学参数的差异; 年龄是影响清除率的一个重要因素, 对高龄患者应适当减少药物剂量; 应用100 mg·m-2表阿霉素患者的耐受性良好。

关键词: 高剂量表阿霉素, 药物动力学, 药效学

Abstract: Objective: This study was designed to characterize the pharmacokinetics and pharmacodynamics of high dose epirubicin in cancer patients. Methods: Eleven patients with malignant tumors were administered with a dose of 100 mg.m-2 epirubicin. The concentration of epirubicin was determined by high-performance liquid chromatographic (HPLC) assay. The modelling data were performed with a compartment pharmacokinetic modelling program (PCNONLIN). Hematological toxicity was used as the pharmacodynamic index. The relationships among the pharmacokinetics and pharmacodynamics and other factors affecting dose modulation were assessed. Results: The pharmacokinetics of high dose epirubicin was best described by a typical three-compartment model. It showed wide interindividual variation. There was no correlation between its pharmacokinetics and pharmacodynamics. Age was closely correlated with epirubicin clearance. Conclusions: There was no difference in the pharmacokinetic parameters between high dose and low dose. Total clearance appeared to decrease with age, which indicates the necessity of reducing dose for the elderly patients. The tolerance was good for patients receiving a dose of 100 mg.m-2 epirubicin.

Key words: High dose epirubicin, Pharmacokinetics, High dose epirubicin, Pharmacokinetics, Pharmacodynamics, Pharmacodynamics

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