个体化诊疗模式在胃肠道恶性肿瘤中预防中度致吐性化疗方案的临床观察  

Prevention of moderate chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer using an individualized treatment model

作　　者：王龙[1] 吴朝君 王丽曼 洪雷[1] 胡新彦[1] 刘志敏[1] 范志松[1] 张雪[1] 刘嘉寅[1] 刘巍[2] Long Wang;Zhaojun Wu;Liman Wang;Lei Hong;Xinyan Hu;Zhimin Liu;Zhisong Fan;Xue Zhang;Jiayin Liu;Wei Liu(Department of Medical Oncology,Fourth hospital of Hebei Medical University,Shijiazhuang 050000,China;Palliative Care Center&Day Care,Key laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Peking University Cancer Hospital&Institute,Beijing 010000,China)

机构地区：[1]河北医科大学第四医院肿瘤内科,石家庄市050000 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所姑息治疗中心&日间化疗病区,恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中国肿瘤临床》2021年第5期235-242,共8页Chinese Journal of Clinical Oncology

基　　金：北京市医院管理局“使命”计划专项经费(编号:SML20181102);中华人民共和国人力资源和社会保障部百千万工程领军人才万人计划资助。

摘　　要：目的:分析真实世界中化疗引起的恶心和呕吐(chemotherapy-induced nausea and vomiting,CINV)的个体化诊疗模式对胃肠道恶性肿瘤患者的CINV控制效果及对生存质量的影响。方法:选取2018年10月至2020年10月就诊于河北医科大学第四医院接受中度致吐风险化疗方案的289例胃肠道恶性肿瘤患者,按照CINV评估治疗方法分为CINV个体化诊疗组(A组)和医师选择诊疗组(B组),分析比较两组CINV控制效果及对生存质量的影响。结果:289例患者中A组146例,B组143例。A组全程恶心(74.66%vs.34.27%,P<0.001)、呕吐(87.67%vs.55.94%,P<0.001)完全控制率均明显优于B组,A组急性期及延迟期恶心、呕吐完全控制率优于B组。同时,A组患者在生存质量的功能领域(躯体功能、角色功能、社会功能),症状领域(恶心呕吐、疲倦、失眠、厌食),以及总体健康状况方面均表现出显著的优势。结论:个体化CINV诊疗模式可显著改善真实世界中胃肠道恶性肿瘤患者的CINV控制率和生存质量。Objective:To analyze the effect of individualized diagnosis and treatment of chemotherapy-induced nausea and vomiting(CINV)in the real world on the control rate of CINV and quality of life in patients with gastrointestinal cancer.Methods:From October 2018 to October 2020,289 patients with gastrointestinal cancer who were admitted to the Fourth Hospital of Hebei Medical University and received a chemotherapy regimen with moderate CINV risk were recruited.Patients were assigned into an individualized CINV treatment group(group A)and a doctor evaluation treatment group(group B).The control rate of CINV and its influence on quality of life were compared between the two groups.Results:There were 146 and 143 cases in groups A and B,respectively.The complete control rates of nausea(74.66%vs.34.27%,P<0.001)and vomiting(87.67%vs.55.94%,P<0.001)were significantly better in group A than in group B.The complete control rates of nausea and vomiting during the acute and delayed phases in group A were significantly better than those in group B.Meanwhile,patients in group A showed significant advantages in terms of quality of life,with respect to functional domains(physical function,role function,and social function),symptom domains(nausea and vomiting,fatigue,insomnia,and anorexia),and overall health status.Conclusions:Individualized CINV treatment can significantly improve the CINV control rate and quality of life in patients with gastrointestinal cancer.

关 键 词：化学治疗 恶心 呕吐 个体化 生存质量 胃癌 结直肠癌 

分 类 号：R735[医药卫生—肿瘤]