Objective: The study aimed to explore the efficacy of pharmacokinetic-based 5-fluorouracil
dose management by plasma concentration test in advanced colorectal cancer treatment.
Methods: 153 samples of advanced colorectal cancer patients were enrolled and randomly assigned to a
control group and an experimental group. All patients received double-week chemotherapy with 5-
fluorouracil (four weeks were used as one period), and chemotherapy duration ranged from 2 to 6 periods.
In the first period, all patients were administered with the classic strategy of body surface area (BSA).
Results: In the subsequent periods, the control group (77 samples) continued with BSA guided chemotherapy,
while the experimental group (76 samples) received pharmacokinetic AUC-based chemotherapy.
The efficacy and toxic side effects were assessed during chemotherapy, and survival was recorded
in a follow-up. In the AUC experimental group, the rate of diarrhea significantly decreased (37.50%
vs. 70.00%, P=0.010), and incidence of oral mucositis reduced (54.17% vs. 82.50%, P=0.014). Compared
with the control group, the clinical benefit rate of experimental group was much higher (90.79%
vs. 79.22%, P=0.046).
Conclusion: There was no significant difference in other 5-fluorouracil related toxic side effect events
(nausea, vomiting, hand-foot syndrome) and progression-free survival between the two groups. Pharmacokinetic-
based dose management of 5-Fluorouracil reduces the toxicity of chemotherapy and improves
long-term efficacy of chemotherapy for advanced colorectal cancer patients.