奥氮平联合常规止吐治疗防治实体瘤化疗相关性呕吐的疗效及对生活质量的影响  

Olanzapine combined with normal antiemetic drugs in patients on solid tumor chemotherapy:Antiemetic effect and impact on quality of life

作　　者：孟琦[1] 陈国华[1] 郭培民[2] 

机构地区：[1]德州市人民医院肿瘤科,山东省德州市253014 [2]德州市人民医院病理科,山东省德州市253014

出　　处：《世界华人消化杂志》2016年第7期1117-1123,共7页World Chinese Journal of Digestology

摘　　要：目的:观察奥氮平在防治化疗相关性恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)方面的作用和安全性,其次是评估奥氮平对肿瘤患者化疗期间生活质量的影响.方法:120例接受高度或中度致吐化疗药物的肿瘤患者被随机分成试验组或对照组.试验组和对照组均自化疗第1天起给予格拉司琼(3 mg qd)+地塞米松(5 mg iv qd)至化疗结束,试验组同时自化疗第1天开始口服奥氮平(2.5 mg bid)至化疗第5天;所有患者在化疗过程中都需填写CINV观察表,在化疗期间需同时填写EORTC QLQ-C30 QOL观察表.主要观察目标是急性期(化疗后24 h内)和延迟期(化疗24 h后)恶心、呕吐的完全缓解率(无恶心及呕吐,不需解救治疗)和有效控制率.其次是观察两组患者生活质量和药物不良反应.结果:与对照组相比,实验组急性期高致吐及中致吐组恶心、呕吐的完全缓解率分别提高10.6%(48.5%vs 37.9%,P=0.01),17.8%(63.0%vs 45.2%,P=0.008),有效控制率分别提高22.0%(90.9%vs 68.9%,P=0.00),24.9%(92.6%vs 67.7%,P=0.001),延迟期高致吐及中致吐组恶心、呕吐的完全缓解率分别提高了14.8%(35.5%vs 20.7%,P=0.04),14.4%(37.0%vs 22.6%,P=0.02),有效控制率分别提高29.6%(84.8%vs 55.2%,P=0.001),29.8%(81.4%vs 51.6%,P=0.002),均有统计学意义;与对照组相比,实验组在整体健康状况、情绪、社会功能、恶心及呕吐、失眠和食欲减退等方面均有明显优势.两组治疗不良反应无明显差异,均耐受良好.结论:奥氮平可以提高化疗相关性恶心、呕吐的控制率,同时能够提高肿瘤患者在化疗期间的生活质量,提高患者的依从性.奥氮平在防治CINV方面是安全、有效的.AIM：To evaluate the efficacy and safety of olanzapine for prevention of chemotherapyinduced nausea and vomiting（CINV） in patients receiving highly or moderately emetogenic chemotherapy（HEC or MEC）,and to evaluate the impact of olanzapine on quality of life（QOL） in cancer patients on chemotherapy.METHODS：One hundred and twenty patients receiving highly or moderately emetogenic chemotherapy were randomly assigned to a study group and a control group,with 60 cases in each group.Routine antiemetics were used in the control group,and olanzapine（2.5 mg,bid,p.o） was add in the study group.All patients were asked to fill the observation form of CINV once a day,and they were also instructed to fill the EORTC QLQ-C30 questionnaire during the period of chemotherapy.Primary endpoints were complete response（CR） and effective response（ER） in the acute and delayed periods.Secondary endpoints were QOL during chemotherapy,drug safety and toxicity.RESULTS：Complete response rates for acute nausea and vomiting in patients with highly and moderately emetogenic chemotherapy were improved by 10.6%（48.5%vs 37.9%,P= 0.01） and 17.8%（63.0%vs 45.2%,P = 0.008）,respectively.Effective response rates for acute nausea and vomiting in patients with highly and moderately emetogenic chemotherapy were improved by 22.0%（90.9%vs 68.9%,P= 0.00） and 24.9%（92.6%vs 67.7%,P = 0.001）,respectively.Complete response rates for delayed nausea and vomiting in patients with highly and moderately emetogenic chemotherapy were improved by 14.8%（35.5%vs 20.7%,P = 0.04） and 14.4%（37.0%vs 22.6%,P = 0.02）,respectively.Effective response rates for delayed nausea and vomiting in patients with highly and moderately emetogenic chemotherapy were improved by 29.6%（84.8%vs 55.2%,P = 0.001） and 29.8%（81.4%vs 51.6%,P = 0.002）,respectively.All patients were evaluable for QOL.When comparing the study group with the control group in QOL,significant differences were seen in global health status,emotional functioning,socia

关 键 词：奥氮平 化疗 恶心 呕吐 生活质量 

分 类 号：R730.53[医药卫生—肿瘤]