DRUG-MONITORING OF 5-FLUOROURACIL - IN-VIVO F-19 NMR-STUDY DURING 5-FU CHEMOTHERAPY IN PATIENTS WITH METASTASES OF COLORECTAL ADENOCARCINOMA

被引：44

作者：

SCHLEMMER, HP

BACHERT, P

SEMMLER, W

HOHENBERGER, P

SCHLAG, P

LORENZ, WJ

VANKAICK, G

机构：

[1] Chirurgische Klinik der Universität

来源：

MAGNETIC RESONANCE IMAGING | 1994年 / 12卷 / 03期

关键词：

IN VIVO F-19 NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY; 5-FLUOROURACIL; DRUG MONITORING; COLORECTAL ADENOCARCINOMA; TUMOR RESPONSE;

D O I：

10.1016/0730-725X(94)92544-5

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

The metabolism of 5-fluorouracil (5-FU) is complex and the reason for the low response rate of tumor patients to 5-FU is currently unknown. The aim of this study was to evaluate whether spectral parameters obtained noninvasively by in vivo F-19 nuclear magnetic resonance (NMR) spectroscopy can be used to assess individual response to 5-FU chemotherapy. Eighteen patients with metastases of colorectal carcinoma treated with 5-FU were examined by F-19 NMR at 1.5 T. The NMR signal intensity versus time curves were observed for the cytostatic and its catabolite alpha-fluoro-beta-alanine (FBAL). Clinical response to treatment was monitored by CT/MR imaging of the liver and carcinoembryonic antigen (CEA) levels in the serum. 5-FU levels observed in IV-treated patients correlate with volumes of metastases in the liver region examined with the F-19 NMR coil (k = 0.77, p <.0001). 5-FU levels in patients at their initial 5-FU chemotherapy were related with clinical response determined after three cycles of treatment. In the group of patients with extensive liver involvement and IV treatment, responders (n = 3) had enhanced 5-FU levels compared to nonresponders (n = 3). FBAL data indicate an apparent saturation of 5-FU catabolism in the liver for 5-FU doses >1 g infused during 10 min. Mean absolute concentrations of FBAL were about 1 pmol per gram liver tissue. F-19 NMR spectroscopy could be used to guide dose escalation schemes or to assess the modulation of 5-FU metabolism by other drugs in combined chemotherapy.

引用

页码：497 / 511

页数：15

共 26 条

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