阿瑞匹坦单药或不同止吐药物联合预防顺铂化疗所致恶心、呕吐  

Aprepitant monotherapy or different antiemetic regimens in prevention of nausea and vomiting caused by cisplatin

作　　者：谢王踢 翁洁 文芳 沈二栋 肖佳 罗盘 粟钰琪 胡佳慧 XIE Wang-ti;WENG Jie;WEN Fang;SHEN Er-dong;XIAO Jia;LUO Pan;SU Yu-qi;HU Jia-hui(Department of Oncology;Department of Gynecology,the First People ＇s Hospital of Yueyang,Yueyang HU-NAN 414000,China)

机构地区：[1]岳阳市一人民医院肿瘤科,湖南岳阳414000 [2]岳阳市一人民医院妇科,湖南岳阳414000

出　　处：《中国新药与临床杂志》2018年第7期405-408,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨阿瑞匹坦、两联或三联止吐药物预防顺铂化疗所致急性期和迟发性恶心、呕吐(CINV)的有效性及安全性。方法已接受含顺铂[第1日至第3日,25 mg·m-2,静脉滴注(静滴)]化疗方案恶性肿瘤患者139例,随机分为单药组(n=31)、双药组(n=52)和三药组(n=56)。单药组予阿瑞匹坦(第1日,125 mg,po;第2日至第3日,80 mg,po,化疗前1 h给药)单药治疗,双药组予格拉司琼(第1日至第3日,3 mg,静滴,化疗前30 min给药)+地塞米松(第1日至第3日,10 mg,静脉推注)治疗,三药组予阿瑞匹坦+格拉司琼+地塞米松(给药方法同前)治疗。观察三组患者急性期(第1日)、迟发性(第2日至第5日)完全有效率(CRR)及不良反应。结果单药组、双药组及三药组急性期CRR分别为74%(23/31)、77%(40/52)和79%(44/56),三组相比无显著差异(P>0.05)。三组迟发性CRR分别为52%(16/31)、52%(27/52)和73%(41/56),其中单药组与双药组相比无显著差异(P>0.05),三药组与其余两组相比均有显著差异(P<0.05)。三组止吐药物治疗相关不良反应主要为便秘、打嗝、困倦、头痛及转氨酶升高等,三组相比均无显著差异(P>0.05)。结论三联止吐药物预防顺铂引起的迟发性CINV疗效优于两联止吐药物及阿瑞匹坦,但阿瑞匹坦在预防顺铂引起的急性期CINV疗效及耐受性方面表现良好。AIM To investigate the safety and efficacy of aprepitant monotherapy, two or triple antiemetic regimens in the prevention of acute and delayed chemotherapy-induced nausea and vomiting（CINV）by cisplatin. METHODS A total of 139 cancer patients who received cisplatin（25 mg·m-2, ivgtt, d1-3） in our hospital were enrolled. They were randomly divided into aprepitant monotherapy group（ n = 31）, two antiemetic drugs group（n = 52） and three antiemetic drugs group（n = 56）. The aprepitant monotherapy group was given aprepitant（ d1, 125 mg, po; d2-3, 80 mg, po, 1 h before chemotherapy）. The two antiemetic drugs group was given glassetron（d1-3, 3 mg, ivgtt, 30 minutes before chemotherapy） and dexamethasone（ d1-3, 10 mg, intravenous injection）. And the three antiemetic drugs group was given aprepitant, glassetron and dexamethasone as the same as the previous two groups. The complete remission rate（ CRR） and adverse reactions of the three groups were observed in the acute phase（ the first day） and the delayed（ 2-5 day）period. RESULTS The acute CRR in the three groups was 74%（ 23/31）, 77%（ 40/52） and 79%（ 44/56）respectively, and there was no statistical difference among them（ P〈0.05）. The delayed CRR in the three groups was 52%（ 16/31）, 52%（ 27/52） and 73%（ 41/56） respectively, and there was no significant difference between the aprepitant monotherapy group and the two antiemetic drugs group（P〈0.05）, but there were significant difference between the three antiemetic drugs group and other two groups（ P〈0.05）. The antiemetic treatment related toxicities were mainly constipation, belch, drowsiness, headache, transaminases,and so on, and there was no significant difference in adverse reactions among the three groups（ P〈0.05）.CONCLUSION Triple antiemetic regimen in the prevention of the delayed CINV caused by cisplatin is better than that of two antiemetic drugs or aprepitant monotherapy. However, aprepitant monotherapy is good in the efficac

关 键 词：阿瑞匹坦 顺铂 恶心 呕吐 

分 类 号：R975.4[医药卫生—药品]