盐酸帕洛诺司琼预防含顺铂化疗所致恶心、呕吐的临床观察  

Effect of palonosetron in prevention of nausea and vomiting induced by cisplatin-based chemotherapy

作　　者：高应勤 陈毅德 冯丽华 郑志高 吕鹭萍 

机构地区：[1]厦门市海沧医院肿瘤科,福建厦门361026

出　　处：《实用肿瘤杂志》2013年第6期654-656,共3页Journal of Practical Oncology

摘　　要：目的通过与格拉司琼比较,观察和评价帕洛诺司琼预防含高度催吐危险化疗药物顺铂所致恶心、呕吐的疗效和安全性。方法采用随机、交叉、自身对照法,将84例含顺铂化疗方案治疗的恶性肿瘤患者分成两组:A组第1周期用帕洛诺司琼及地塞米松;B组第1周期用格拉司琼及地塞米松;第2周期A、B组交叉使用。止吐方案:帕洛诺司琼0.25 mg,静脉推注d1,d3;格拉司琼3 mg,静脉滴注d1-3;地塞米松10 mg,静脉推注d1-3。观察化疗后7天内恶心、呕吐的情况以及与止吐药相关不良反应。结果帕洛诺司琼与格拉司琼对化疗后急性呕吐完全控制率分别为77.4%和71.4%,总有效率分别为90.5%和86.9%,差异均无统计学意义(均P>0.05);帕洛诺司琼与格拉司琼对化疗后延迟性呕吐完全控制率分别为66.7%和47.6%,总有效率82.1%和59.5%,差异均具有统计学意义(均P<0.05);与止吐药相关不良反应主要为便秘和头痛,两药发生率分别为22.6%和25.0%,差异无统计学意义(P>0.05)。结论帕洛诺司琼对预防含顺铂化疗所致的急性呕吐的疗效与格拉司琼相当,但对预防延迟性呕吐的疗效优于格拉司琼,且不良反应发生率低、程度较轻、安全性好。Objective To evaluate the effect of palonosetron in prevention of nausea and vomiting induced by cisplatin-based chemotherapy. Methods The study was designed as a randomized,crossover, self-control study. Eighty-four cancer patients treated with cisplatin-based chemotherapy were divided into two groups with 42 in each group. In the first cycle patients in group A were given with palonosetron and dexamethasone,while for group B granisetron and dexamethasone were given; in the second cycle the drugs were interchanged for group A and group B. The antiemetic regimen was as follows： palonosetron 0.25 mg,iv,dl, d3 ;granisetron 3 mg,iv,dl -3 ;dexamethasone 10 mg,iv,dl -3. The occurrence of nausea,vomiting and antiemetic drug-related adverse reactions were observed in 7d after chemotherapy. Results The complete acute vomiting control rates of palonosetron and granisetron were 77.4% and 71.4% ; the overall effective rates were 90.5% and 86.9% , respectively （P 〉 0.05 ）. The complete delayed vomiting control rates of palonosetron and granisetron were 66.7% and 47.6% ; and the overall effective rates were 82. lifo and 59. 5% , respectively （P 〈 0. 05）. The main adverse reactions related to antiemetic drugs were constipation and headache, the occurrence rates of which were 22. 6% and 25.0% for two drugs （ P 〉 0.05 ）. Conclusions Palonosetron can effectively prevent patients from acute and delayed nausea/vomiting caused by cisplatin-hased chemotherapy with low incidence of adverse reactions. For acute nausea/vomitting, palonosetron is more effective than granisetron.

关 键 词：肿瘤 顺铂 呕吐 恶心 奎宁环类 异喹啉类 吲哚类 统计学(主题) 

分 类 号：R730.5[医药卫生—肿瘤]