吉西他滨治疗非小细胞肺癌的时辰药理学研究

目的:研究吉西他滨的时辰药理学,选择最佳给药时间,以获得最大疗效,减少毒性反应。方法:60例Ⅲ～Ⅳ期非小细胞肺癌(NSCLC)患者随机分为3组。A组(n=20)在8∶00给药,B组(n=20)在14∶00给药,C组(n=20)在20∶00给药。吉西他滨1g·m-2,ivgtt,第1、8天;顺铂75mg·m-2,ivgtt,第1天,第21天重复。测定给药后0.5、1.5、3h的血药浓度,并评价经化疗2周期后的疗效和毒副反应。结果:A、B、C组有效率分别为44.4%、35.3%、38.9%(P>0.05)。给药后3个时间点的血药浓度,3组间差异无统计学意义(P>0.05),但14∶00给药组的毒副反应发生率较高。结论:吉西他滨治疗NSCLC在8∶00给药较为安全、有效。

Chronopharmacology of Gemcitabine in the Treatment of Non-small Cell Lung Cancer

OBJECTIVE： To study the chronopharmacology of gemcitabine in the treatment of advanced non-small cell lung cancer （NSCLC） so as to optimize its medication time and maximize its therapeutic efficacy. METHODS： Sixty patients with locally NSCLC （staged Ⅲ- Ⅳ ） were randomly divided to three groups. Group A （n= 20） was given drugs at 8：00, Group B （n = 20） at 14：00, and Group C （n=20） at 20：00. Gemcitabine 1 g.m^-2 was given by iv gtt on day 1 and day 8; cisplatin 75 mg.m-2 was given by iv gtt on day 1, The treatment cycle was repeated in every 21 days. Serum concentrations of gemcitabine at 0.5 h, 1.5 h and 3 h were determined, and curative efficacy and toxicity after treatment for two cycles were evaluated. RESULTS： The effective rates in Group A, B and C were 44.4%, 35.3% and 38.9%, respectively（P〉0.05）. There were no statistic differences among the 3 groups in serum concentrations of gemcitabine at 0.5 h, 1.5 h and 3 h（P〉0.05） but the incidence of toxicities in Group B was higher than in the other two groups. CONCLUSION ： Comparatively speaking, Gemcitabine administered at 8 ： 00 was proved to be safer and more effective as compared with the other two groups in the treatment of NSCLC.