沙利度胺联合5-HT3受体拮抗剂及地塞米松预防乳腺癌术后化疗所致恶心呕吐的回顾性分析  

Efficacy of thalidomide combined with 5-hydroxytryptmine receptor antagonist and dexamethasone for the prevention of chemotherapy induced nausea and vomiting:A retrospective study

作　　者：秦蓉[1] 周永静[1] 周歧 范钰[1] Qin Rong;Zhou Yongjing;Zhou Qi;Fan Yu(Oncology Department,Affiliated People's Hospital of Jiangsu University,Jiangsu Zhenjiang 212002,China)

机构地区：[1]江苏大学附属人民医院肿瘤科

出　　处：《现代肿瘤医学》2020年第1期58-61,共4页Journal of Modern Oncology

基　　金：江苏省科技项目(编号:BE2015666);江苏省创新团队领军人才基金(编号:QNRC2016446)

摘　　要：目的:观察沙利度胺联合5-HT3受体拮抗剂及地塞米松在乳腺癌患者术后化疗中的止吐效果及不良反应。方法:选取2016年1月至2018年12月江苏大学附属人民医院收治的采用AC/EC方案化疗的乳腺癌术后患者72例,观察组37例,对照组35例。两组均采用第一代5-HT3受体拮抗剂联合地塞米松止吐,观察组同时加用沙利度胺止吐。观察两组患者急性期和延迟性恶心、呕吐的发生情况及不良反应。结果:观察组与对照组急性期恶心、呕吐的完全缓解率分别是45.9%和28.6%,差异无统计学意义(P=0.15),两组总有效率分别是94.6%和88.6%,差异无统计学意义(P=0.423)。观察组与对照组延迟性恶心、呕吐的完全缓解率分别是27.0%和5.7%,差异有统计学意义(P=0.025),两组总有效率分别是97.3%和65.7%,差异有统计学意义(P=0.001)。观察组化疗后便秘、嗜睡发生率高于对照组,差异有统计学意义(P=0.03,P=0.004),而失眠的发生率低于对照组,分别是8.1%和31.4%,差异有统计学意义(P=0.017)。结论:沙利度胺、5-HT3受体拮抗剂和地塞米松三药联合方案预防乳腺癌术后患者化疗所致恶心呕吐特别是延迟性恶心呕吐疗效更好,不良反应可耐受。Objective:To observe the clinical efficacy and adverse reactions of thalidomide combined with 5-hydroxytryptmine receptor antagonist and dexamethasone in the prevention of chemotherapy induced nausea and vomiting in adjuvant chemotherapy breast cancer patients.Methods:72 breast cancer patients who received AC/EC chemotherapy in Affiliated People's Hospital of Jiangsu University from January,2016 to December,2018,were randomly divided into two groups,37 cases in study group and 35 cases in control group.Both groups were treated with double antiemetic therapy with 5-HT3 receptor antagonist and dexamethasone,and the study group was combined with thalidomide simultaneously.Both groups of acute and delayed nausea and vomiting occurred and adverse reaction were observed.Results:The complete remission rates of acute nausea and vomiting in the study group and control group were 45.9%and 28.6%,and the difference was not statistically significant(P=0.15).The effective rates were 94.6%and 88.6%respectively,and the difference was not statistically significant(P=0.423).The complete remission rates of delayed nausea and vomiting in the study group and control group were 27.0%and 5.7%,and the difference was statistically significant(P=0.025).The effective rates were 97.3%and 65.7%respectively,and the difference was statistically significant(P=0.001).After chemotherapy,the incidence rates of constipation and drowsiness in study group were higher than that in control group,and the difference was statistically significant(P=0.03,P=0.004),but the incidence rate of insomnia in study group was lower than that in control group,8.1%and 31.4%respectively,and the difference was statistically significant(P=0.017).Conclusion:The triple antiemetic therapy with thalidomide,5-HT3 receptor antagonist and dexamethasone can effectively prevent chemotherapy-induced nausea and vomiting,especially for delayed CINV,in breast cancer patients after modified radical mastectomy,and worthy to be popularized.

关 键 词：沙利度胺 乳腺癌 化疗 恶心 呕吐 

分 类 号：R737.9[医药卫生—肿瘤]