帕洛诺司琼联合地塞米松预防顺铂化疗所致恶心呕吐的临床研究  

A Clinical Trail of Polonosetron Plus Dexamethasone in Preventing Cisplatin-Based Chemotherapy Induced Nausea and Vomiting

作　　者：于礼建[1] 龙桂宁[1] 崔建东[1] 张为民 黄彦泽 黄雪琴 谭红香[3] 魏旺荣[4] 

机构地区：[1]解放军303医院肿瘤内科,南宁530021 [2]广州军区陆军总医院肿瘤内科 [3]广州市儿童医院神经康复科 [4]中山大学第五附属医院

出　　处：《天津医药》2010年第11期974-976,共3页Tianjin Medical Journal

摘　　要：目的:评价帕洛诺司琼联合地塞米松预防顺铂化疗引起的恶心、呕吐的有效性和安全性。方法:将用顺铂(≥50mg/m2)化疗方案的72例患者随机分为观察组35例,对照组37例,观察组于化疗前30min缓慢静脉注射帕洛诺司琼0.25mg,对照组静脉滴注托烷司琼2mg,2组均于第1、2、3天化疗前分别静脉滴注地塞米松16、8、8mg,观察患者化疗引起的急性期、延迟期及全期呕吐的完全缓解率(CRR)及无呕吐发作百分率,必要时给予解救性止吐治疗(托烷司琼或甲氧氯普胺)。结果:2组急性期、延迟期CRR比较差异无统计学意义(P>0.05),但观察组全期CRR高于对照组(P<0.05);2组急性期无呕吐发作率比较差异无统计学意义(P>0.05),但在延迟期及全期差异有统计学意义(P<0.05)。2组不良反应主要为头痛、便秘、眩晕及腹部不适等,均症状轻微,患者耐受性好。结论:帕洛诺司琼联合地塞米松能有效地预防高致吐性化疗药所致急性期、延迟期呕吐反应,对于延迟期呕吐反应其疗效优于托烷司琼,且安全性高。Objective： To observe and assess the efficacy and safety of palonosetron plus dexamethasone in preventing cisplatin-based chemotherapy induced nausea and vomiting. Methods： This study was performed as a randomized,clinical control trial. Seventy-two patients administered highly emetogenic cisplatin-based （≥50 mg/m2） chemotherapy were included in the clinical trail. Patients were received a single dose of palonosetron 0.25 mg i.v. bolus （treatment group, n = 35）, and tropisetron 2 mg i.v. drop （control group, n = 37）. Dexamethasone （16 mg, 8 mg and 8 mg） was administered on day 1, 2 and 3 before chemotherapy in patients of the two groups. The complete remission rate （CRR） of vomiting and percentage of no vomiting attack were observed during the acute phase （0-24 h post chemotherapy）, delayed phase （24-120 h post chemotherapy） and both phases （0-120 h post chemotherapy） in patents of groups. Patients were administered methoxychlorproeainamide for rescue therapy if needed. Results： There was no significant difference in CRR during acute phase and delayed phase between treatment group and control group （P 0.05）. The CRR of both phase （0-120 h post chemotherapy）was significantly higher in treatment group than that of control group（P 0.05）.There was no significant difference in percentage of no vomiting attack during acute phase （P 0.05）, but there was a significant difference during delayed phase and both phases （P 0.05） between treatment group and control group. The adverse reaction were mild and generelly well tolerated included headache, constipation, dizzy and abdominal discomfort in patients of two groups. Conclusion： The therapy of palonosetron plus dexamethasone is effective and safe for preventing both acute and delayed nausea and vomiting in patients with highly emetogenic chemotherapy, which is superior to tropisetron in preventing chemotherapy-induced delayed nausea and vomiting.

关 键 词：抗肿瘤联合化疗方案 顺铂 恶心 呕吐 受体 血清素 5-HT3 帕洛诺司琼 托烷司琼 

分 类 号：R975[医药卫生—药品]