發(fā)布時間：2018-04-08 23:37

  本文選題：多日化療　切入點：惡心　出處：《中國腫瘤臨床》2017年13期

【摘要】：目的:探討重復(fù)使用第一代5-HT3受體拮抗劑(5-HT3RA)托烷司瓊與第二代5-HT3RA帕洛諾司瓊預(yù)防多日高度催吐風(fēng)險化療所致惡心和嘔吐(chemotherapy-induced nausea and vomiting,CINV)的療效和安全性。方法:在接受含有高度催吐風(fēng)險藥物連續(xù)多日化療的患者中,采用隨機、交叉自身對照的方法分組,A方案組為:在第1周期化療中,帕洛諾司瓊0.25 mg,靜脈滴注,d1、d3(必要時d5)。地塞米松(DXM)10 mg,靜脈滴注,d1;5 mg,靜脈滴注,d2~d5。第2周期為托烷司瓊5 mg,靜脈滴注,d1~d3(必要時d4、d5);DXM用法同前。B方案組的止吐方案為第1周期使用托烷司瓊,第2周期使用帕洛諾司瓊(劑量、用法均同A方案組)。將A方案組第1個周期和B方案組第2個周期的患者歸為帕洛諾司瓊組,A方案第2個周期和B方案組第1個周期的患者歸為托烷司瓊組,比較帕洛諾司瓊與托烷司瓊預(yù)防CINV的療效和不良反應(yīng)。結(jié)果:共計入組91例患者。在d3至d5,帕洛諾司瓊組每天惡心發(fā)生率分別為28.6%、30.8%和24.2%,托烷司瓊組分別為42.8%、47.3%和39.6%,差異均有統(tǒng)計學(xué)意義(均P0.05);在d4至d6,帕洛諾司瓊組每天嘔吐發(fā)生率分別為28.6%、18.7%和5.5%,托烷司瓊組則為42.9%、34.1%和14.3%,差異均有統(tǒng)計學(xué)意義(均P0.05);按時間段分析,帕洛諾司瓊組在d4~5、d6~7和全程(d1~7)惡心和嘔吐發(fā)生率均顯著低于托烷司瓊組(均P0.05)。帕洛諾司瓊組全程(d1~7)解救藥使用率為13.2%,低于托烷司瓊組的24.2%,但差異無統(tǒng)計學(xué)意義(P=0.057)。帕洛諾司瓊組與托烷司瓊組的止吐藥物相關(guān)性不良反應(yīng)發(fā)生率的差異均無統(tǒng)計學(xué)意義(均P0.05)。結(jié)論:重復(fù)使用帕洛諾司瓊預(yù)防持續(xù)多日高度催吐風(fēng)險化療相關(guān)的延遲性惡心嘔吐的療效優(yōu)于托烷司瓊,兩者的安全性良好。
[Abstract]:Objective: To investigate the effects of repeated use of first generation 5-HT3 receptor antagonist (5-HT3RA) of tropisetron and palonosetron to prevent the second generation 5-HT3RA days high emetic risk of chemotherapy-induced nausea and vomiting (chemotherapy-induced nausea and vomiting, CINV) efficacy and safety. Methods: in risk of drug containing highly urge patients vomit consecutive days of chemotherapy in a randomized, crossover self control method group, A group: in the first cycle of chemotherapy, palonosetron 0.25 mg, intravenous drip, D1, D3 (D5 if necessary). Dexamethasone (DXM) 10 mg, intravenous drip, D1; 5 mg, intravenous drip, d2~d5. the second cycle of tropisetron 5 mg, intravenous drip, d1~d3 (if necessary, D4, D5); the usage of the DXM.B scheme with antiemetic regimen group was first cycles using tropisetron, second cycles with palonosetron (dose, usage are the same as the A group). A group first cycle and B 妗堢粍絎，

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