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首页> 外文期刊>癌と化学療法 >TS-1 treatment for progressive gastric cancer in a patient on chronic dialysis--assessment of dosage regimen by monitoring blood concentrations of therapeutic drugs (TDM)
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TS-1 treatment for progressive gastric cancer in a patient on chronic dialysis--assessment of dosage regimen by monitoring blood concentrations of therapeutic drugs (TDM)

机译:慢性透析患者进行渐进胃癌的治疗 - 通过监测治疗药物血液浓度评估剂量方案(TDM)

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The optimum dose of TS-1 for the treatment of peritoneally disseminated gastric cancer in a patient with chronic renal failure undergoing chronic dialysis was estimated by monitoring the blood concentrations of 5-FU and gimeracil (CDHP) [therapeutic drug monitoring (TDM)] during administration of TS-1. Immediately after dialysis, 50 mg or 40 mg of TS-1, corresponding to 50% and 40% of the standard dose (100mg for this patient), respectively, was administered orally once a day every other day, and TDM was conducted. Compared with the pharmacokinetic parameters of 5-FU at the time of the initial administration of 50 mg or 40 mg of TS-1 and that of cancer patients with normal renal function, the AUC shown in the administration of 40 mg was equivalent to that observed with a single safe dose of 100 mg in patients with normal renal function. Based on this observation, the daily TS-1 dose was set at 40 mg in this patient, and TS-1 treatment was started after confirming the absence of the accumulation of 5-FUor CDHP during repeated administrations. In this treatment protocol, TS-1 was administered 11 times at a daily dose of 40 mg every other day immediately after dialysis, followed by a rest. This .administration schedule was defined as one course. Under these conditions, the patient was treated on an outpatient basis, and the treatment could be safely continued without the development of any severe adverse events, such as myelosuppression.
机译:通过监测5-FU和Gimeracil(CDHP)的血液浓度[治疗药物监测(TDM)]估计,估计慢性肾功能衰竭患者慢性肾功能衰竭的患者患者腹膜缺陷胃癌的最佳剂量。施用TS-1。在透析后,在每隔一天,每隔一天一次施用50mg或40mg的TS-1,分别对应于50%和40%的标准剂量(对于该患者的40%),并进行一次TDM。与5-FU的药代动力学参数相比,在初始施用50毫克或40mg TS-1的时间和癌症患者的正常肾功能时,40mg给药中所示的AUC相当于观察到的在肾功能正常的患者中,单一安全剂量为100毫克。基于该观察,在该患者中,每日TS-1剂量设定为40mg,并且在确认在重复施用期间没有5倍CDHP的累积后开始TS-1处理。在该治疗方案中,在透析后立即每隔一天的每日剂量为40毫克,然后静置施用TS-1。此。发出计划被定义为一门课程。在这些条件下,患者在门诊基础上进行处理,并且可以安全地继续进行治疗,而不会发生任何严重不良事件,例如骨髓抑制。

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