阿瑞匹坦预防胃癌术后化疗恶心呕吐反应68例临床观察  

Antiemetic effect of aprepitant for chemotherapy-induced nausea and vomiting in 68 adjuvant chemotherapy gastric cancer patients

作　　者：石林[1] 钱志英[1] 徐霞[1] 周斌[1] 袁渊[1] 沈波[1] 

机构地区：[1]南京医科大学附属江苏省肿瘤医院肿瘤内科,江苏南京210009

出　　处：《中国肿瘤外科杂志》2016年第6期388-390,393,共4页Chinese Journal of Surgical Oncology

基　　金：吴阶平基金(320.6750.13231)

摘　　要：目的探讨阿瑞匹坦预防胃癌术后患者行含奥沙利铂化疗方案所致的恶心呕吐的临床疗效及不良反应。方法选取2014年4月至2016年6月江苏省肿瘤医院收治的接受含奥沙利铂方案化疗2周期的胃癌术后患者68例为研究对象。化疗第一周期使用帕洛诺司琼+地塞米松二联方案预防呕吐,第二周期使用阿瑞匹坦+帕洛诺司琼+地塞米松三联方案预防呕吐。记录患者化疗开始后7天的恶心呕吐情况;使用视觉模拟评分法(VAS)进行生活质量评估。结果化疗第一周期后有67.6%患者呕吐达到完全缓解,化疗第二周期后有85.3%的患者呕吐达到完全缓解(P<0.01)。在延迟性呕吐预防效果的比较中,二联方案呕吐控制率为70.6%,加入阿瑞匹坦后提高到92.6%(P<0.01)。第二周期化疗后VAS评分(92.3)明显高于第一周期化疗后的89.2(P<0.01)。结论胃癌术后患者使用阿瑞匹坦+帕洛诺司琼+地塞米松预防含奥沙利铂化疗方案化疗所致恶心呕吐的疗效良好,能提高患者的生存质量。Objective To observe the clinical efficacy and adverse reactions of aprepitant in the prevention of nausea and vomiting induced by oxplatin-based adjuvant chemotherapy in gastric cancer patients.Methods68 surgical gastric cancer patients who received oxplatin-based chemotherapy in Jiangsu Cancer Hospital from April,2014 to June,2016,were treated with doublet antiemetic therapy with dexamethasone and a 5-HT3 receptor antagonist during the first cycle of chemotherapy.Aprepitant was then added during the second cycle of chemotherapy.The primary endpoint was overall complete response rate,defined as no vomiting and no rescue therapy during the 7 day after administration of chemotherapy.The functional living index-emesis was adopted to assess patients＇ quality of life with VAS.Results The overall complete response rate was significantly improved in the second cycle（ 85.3 %） compared with the first cycle（ 67.6%,P〈0.01）.Improvement was also observed in the delayed phase 92.6% VS 70.6%,but not in the acute phase.The FLIE score of aprepitant group and control group were 92.3% and 89.2（ P〈0.01） respectively.Conclusion Subsequent addition of aprepitant significantly improved the overall complete response rate in gastic patients receiving a second cycle of oxplatinbased adjuvant chemotherapy.

关 键 词：阿瑞匹坦 奥沙利铂 胃癌 术后化疗 呕吐 化疗反应 

分 类 号：R735.2[医药卫生—肿瘤]