女性肺癌和乳腺癌患者中阿瑞匹坦与奥氮平预防多日化疗所致延迟性恶心呕吐的疗效观察  

Aprepitant versus Olanzapine for Prevention of Nausea and Vomiting Induced by Multiday Chemotherapy in Female Lung Cancer or Breast Cancer Patients

作　　者：董爽[1] 王俊[1] 胡胜[1] 廖国祥 冉凤鸣[1] 

机构地区：[1]湖北省肿瘤医院胸部肿瘤内科,武汉430079 [2]荆州市第三人民医院肿瘤科,荆州434000

出　　处：《肿瘤防治研究》2017年第5期356-359,共4页Cancer Research on Prevention and Treatment

摘　　要：目的评估阿瑞匹坦/奥氮平联合托烷司琼和地塞米松方案在多日顺铂化疗的女性患者中的有效性、安全性和费用效益比。方法采用随机对照研究方法,将87例女性肿瘤患者随机分为阿瑞匹坦组(44例)和奥氮平组(43例)。阿瑞匹坦组止吐方案:阿瑞匹坦、托烷司琼和地塞米松;对照组方案:奥氮平、托烷司琼和地塞米松。结果 44例阿瑞匹坦组患者中,29例患者(65.9%)延迟期呕吐达到完全缓解,43例患奥氮平组患者中,30例(69.8%)延迟期呕吐达到完全缓解,两组比较差异无统计学意义(P=0.690)。阿瑞匹坦组呃逆发生率更高(P=0.023),其余不良反应两组差异无统计学意义;而奥氮平导致的嗜睡作用更明显(P=0.006)。血液学毒性方面两组之间差异无统计学意义。每周期阿瑞匹坦组的费用明显高于奥氮平组(P<0.01)。结论奥氮平联合托烷司琼和地塞米松用于女性肺癌和乳腺癌患者多日化疗所致的延迟性恶心呕吐安全性和有效性与阿瑞匹坦联合托烷司琼和地塞米松相似,但更具有费用效益比优势。Objective To compare the effectiveness, safety and cost-effectiveness ratio between Olanzapine （OLN） and Aprepitant （APR） for the prevention of chemotherapy-induced nausea and vomiting （CINV） in female patients who received multi-day cisplatin-based chemotherapy. Methods Eighty-seven female patients were randomized to receive Aprepitant （44 cases） or Olauzapine （43 cases）. Antiemetic regimen received by Aprepitant group and olzanpine group were as follows. Aprepitant group： Aprepitant, Tropisetron and Dexamethasone; Olanzapine group： Olanzapine, Tropisetron and Dexamethasone. Results No substantial difference was found in complete response rate of delayed emesis in Aprepitant group （29/44） and in Olanzapiue group （30/43）, （65.9% vs. 69.8%, P=0.690）. Higher hiccup incidence was found in Aprepitant group （31.8%, P=0.023） while a more pronounced drowsiness effect was observed in Olanzapine group （25.6%, P=0.006）. Hematological toxicity between the two groups was of no significant difference. Yet, the cost of Aprepitant group per cycle was much higher than that of Olanzapine group （P〈0.01）. Conclusion In female lung and breast cancer patients, the safety and effectiveness of Aprepitant combined with Dexamethasone and Tropisetron are similar to those of Olanzapine regarding delayed nausea and vomiting induced by 3 days Cisplatin chemotherapy, but the latter is more cost-effective.

关 键 词：阿瑞匹坦 奥氮平 顺铂 化疗 化疗所致恶心呕吐 

分 类 号：R730.53[医药卫生—肿瘤]