阿瑞匹坦解救治疗45例暴发性化疗诱导恶心呕吐的效果和安全性分析  

Analysis on the efficacy and safety of aprepitant in rescuing 45 cases with breakthrough chemotherapy-induced nausea and vomiting

作　　者：郑琪[1] 周菁[1] 张彦兵[1] 马婕群 翟阳[1] 李索妮[1] 廖子君[1] Zheng Qi;Zhou Jing;Zhang Yanbing;Ma Jiequn;Zhai Yang;Li Suoni;Liao Zijun(Department of Medical Oncology,Affiliated Shaanxi Provincial Tumor Hospital,College of Medicine,Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学医学院附属陕西省肿瘤医院肿瘤内科,西安710061

出　　处：《中国肿瘤临床与康复》2023年第6期386-391,共6页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：陕西省卫生计生科研基金项目(2016D050)。

摘　　要：目的 探索阿瑞匹坦解救治疗45例暴发性化疗诱导恶心呕吐(CINV)的效果和安全性.方法 收集2016年1月至2018年6月陕西省肿瘤医院肿瘤内科接受阿瑞匹坦用于化疗止吐的病例,筛选其中暴发性CINV病例45例进行分析.所有的患者化疗前均使用包含5-羟色胺3受体拮抗剂和地塞米松在内的二联止吐方案,化疗后0~120 h出现了Ⅱ~Ⅲ级暴发性CINV.首先给予肌内注射甲氧氯普胺或苯海拉明,当恶心呕吐症状稍减轻,不影响口服药物时,给予口服阿瑞匹坦(第1日口服125 mg,第2和3日均口服80 mg)解救治疗,详细记录用药后72h内消化道反应,评价疗效,统计分析暴发性CINV的缓解率与一系列临床因素间的关系.结果 阿瑞匹坦解救治疗的总体缓解率为91.1%(41/45)、完全缓解率为15.6%(7/45)、部分缓解率为75.6%(34/45)、无反应率为8.9%(4/45),不良反应轻微且可耐受.统计分析结果显示,暴发性CINV的缓解率与患者性别、年龄、既往化疗史、化疗方案的致吐风险及患者体能状态评分等临床因素不相关(P>0.05).结论 阿瑞匹坦解救治疗暴发性CINV安全有效,值得进一步研究.Objectives To explore the efficacy and safety of aprepitant in rescuing 45 cases with breakthrough chemotherapy-induced nausea and vomiting(CINV).Methods Patients of Department of Medical Oncology,Affiliated Shaanxi Provincial Tumor Hospital who had used aprepitant as antiemetic agent from January 2016 to June 2018 were collected,and 45 patients who experienced breakthrough CINV were selected and analyzed.All patients were given two-agent prophylaxis schedule including 5-hydroxytryptamine 3(5-HT,)receptor antagonists and dexamethasone before chemotherapy,and underwent grade II-II breakthrough CINV within O to 120 h.Rescue schedule(aprepitant 125 mg orally on the first day,80 mg orally on the second and third day)was administered when the symptoms of nausea and vomiting were partly relieved by intramuscular injection of metoclopramide or diphenhydramineand without affecting the oral medication.Then gastrointestinal reactions of therapy in the following 72 h were recorded in detail,the efficacy was evaluated,and the relationship between efficacy and a series of clinical parameters were analyzed.Results The rescue treatment of aprepitant showed a response rate of91.1%(41/45),a complete response rate of 15.6%(7/45),a partial response rate of 75.6%(34/45)and a non-response rate of 8.9%(4/45),while adverse events were mild and endurable.Results of statistical analyses indicated that the response rate was not correlated with clinical factors such as gender,age,chemotherapy history,emetogenicity of chemotherapy regimens,performance status score and so on(P>0.05).Conclusions Aprepitant demonstrates high efficacy and safety in the treatment of breakthrough CINV,which merits furtherinvestigations.

关 键 词：暴发性化疗诱导恶心呕吐 阿瑞匹坦 解救治疗 化疗 

分 类 号：R730.53[医药卫生—肿瘤]