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有30%ALL 不能治愈,原因之一是药物代谢差异。在药物代谢及排出快的人中,全身接触的药物强度减低,CR 率亦低。许多肿瘤,包括ALL,已证明药物强度对疗效有重大影响。每一种抗肿瘤药在病人间,药代动力学参数有显著差别。临床依血象变化调整药量,但不能确定联合用药中是什么药过量,因而最好对每种药进行细胞毒测定,但这对大多数药来说,现在还不具备条件.血清浓度对时间的曲线下面积代表了药物接触强度(AUC)。25个临床研究证明AUC 与效果和副作用相关.作者从1988年10月起,在前瞻性临床试验(Total-12)中对比了常规给药组和随清除率不同而个体化给药组的疗效和毒性。观察对象为150例儿
One of the reasons why 30% of ALL cannot be cured is the difference in drug metabolism. In people with fast drug metabolism and discharge, the drug exposure to systemic contact was reduced, and the CR rate was also low. Many tumors, including ALL, have demonstrated that drug strength has a major effect on efficacy. There is a significant difference in pharmacokinetic parameters between patients for each antitumor drug. The clinical adjustment of the drug dose depends on changes in blood count, but it is not possible to determine what drug overdose is caused by combination therapy. It is therefore best to perform cytotoxicity assays for each drug, but for most drugs, it is not yet available. Serum concentration versus time The area under the curve represents the drug contact strength (AUC). Twenty-five clinical studies have demonstrated that AUC is related to efficacy and side effects. The authors compared the efficacy of the conventional administration group and the individualized administration group with different clearance rates in the prospective clinical trial (Total-12) from October 1988. And toxicity. 150 subjects were observed