慢性肝病时抗肿瘤药物的运用推荐.docVIP

慢性肝病患者常用抗肿瘤药物应用推荐 （文献来源：Periá?ez-Párraga L, Martínez-López I, Ventayol-Bosch P, Puigventós Latorre F, Delgado-Sánchez O. Drug dosage recommendations in patients with chronic liver disease. Rev Esp Enferm Dig 2012; 104: 165-184.） Drug (references) Huet and Kr?henbühl (11,12) category EH Metabolism Q0 PB (%) Recommendation Anastrazole Prod Info Arimidex, 2010 (27) 阿那曲唑 4 Not known 未知 N-dealkylation, hydroxylation (CYP), glucuronidation N-脱烷基作用，羟基化作用CYP)，糖脂化作用 0.95 45 No adjustment required 不需要调整 Letrozole* (9) 来曲唑 3 0.03 Liver metabolism (CYP3A4, 2D6) 肝代谢(CYP3A4, 2D6) 0.95 60 Patients with cirrhosis or with Child-Pugh C index reduced by 50% dose 肝硬化的病人或者C的病人减少50%剂量 Tamoxifen (9) 他莫昔芬 3 0.3 Hydroxylation, demethylation and conjugation 羟基化，脱甲基， 1 99 Monitor liver function in patients with preexisting liver disease 已有肝脏疾病的患者，监测肝功能 Estramustine Prod Info Estracyt, 2006 (27) 雌莫司汀 4 Not known Hydroxylation and glucuronidation 糖脂化和羟基化作用 0.9 99 Precaution Melphalan* (9) 美法仑 2 0.31 Hydroxylation 羟基化作用 0.9 80 No adjustment required 不需要调整 Goserelin* Prod Info Zoladex, 2010 (27) 戈舍瑞林 3 0.04 – 0.4 25 No adjustment required 不需要调整 Buserelin 布舍瑞林 3 Not known 未知 – Not calculable 无法计算 Leuprorelin 亮丙瑞林 3 0.05 – 46 ** Maintenance dose: CP A: 50% of normal dose CP B: 25% of normal dose CP C: drug monitoring 持续剂量：CPA：50%正常剂量 CPB：25%正常剂量 CPC: 监测药物 Tioguanine Prod Info Tioguanina Glaxosmithkline, 2007 (27) 硫鸟嘌呤 4 Not known Metabolism thiopurine methyltransferase 代谢甲基转移酶 0.9 5.0-9.0 Monitor liver function 监测肝功能 Mercaptopurine* (9) 2 0.46 Extensive liver metabolism: xantino-oxidasa 广泛肝代谢：黄嘌呤氧化酶 0.9 19 Monitor liver function 监测肝功能 Azathioprine Prod Info Imurel, 2007 (27) 硫唑嘌呤 2 0.4 Oxidation 氧化作用 30 Precaution 慎用 Bicalutamide* (9) 比卡鲁胺 2 0.34 Oxidation (CYP), glucuronidation 氧化作用(CYP), 糖脂化（作用） 1 98 Monitor liver function. If transaminases three times normal or bilirubin value