奈妥匹坦帕洛诺司琼在造血干细胞移植前的全身放疗中对消化道的保护作用  

Analysis of the protective effect of netupitant/palonosetron(NEPA)on the digestive tract during total body irradiation before hematopoietic stem cell transplantation

作　　者：范艺芯 岳养军 肖楠 唐宇辰 王香 井旭 夏艺 袁立文 Fan Yixin;Yue Yangjun;Xiao Nan;Tang Yuchen;Wang Xiang;Jing Xu;Xia Yi;Yuan Liwen(Department of Radiotherapy,Chengdu BOE Hospital,Chengdu 610000,China)

机构地区：[1]成都京东方医院放疗科,610000

出　　处：《山西医药杂志》2025年第3期171-175,共5页Shanxi Medical Journal

摘　　要：目的探索奈妥匹坦帕洛诺司琼胶囊在造血干细胞移植前全身放疗中对消化道的保护作用。方法回顾性分析成都京东方医院2021年9月至2024年6月接受全身放疗为预处理方案的造血干细胞移植病例73例,其中全身放疗前口服奈妥匹坦帕洛诺司琼胶囊的病例为观察组,全身放疗前不口服奈妥匹坦帕洛诺司琼胶囊的病例为对照组,比较2组患者治疗期间出现恶心、呕吐、应用肠外营养情况、造血干细胞植入时间及奈妥匹坦帕洛诺司琼胶囊相关不良反应。组间比较采用χ^(2)检验、秩和检验进行统计。结果观察组患者39例(53%),对照组患者34例(47%)。观察组出现恶心反应的患者Ⅰ级15例,对照组出现恶心反应的患者Ⅰ级21例,Ⅱ级11例;观察组出现呕吐反应的患者Ⅰ级6例,Ⅱ级1例,对照组出现呕吐反应的患者Ⅰ级11例,Ⅱ级18例,Ⅲ级1例,2组对比差异均具有统计学意义(P<0.001)。观察组应用肠外营养1例,对照组应用肠外营养7例,2组对比差异具有统计学意义(P=0.017)。全身放疗结束到回输造血干细胞的时间,观察组中位时间为5(1,8)d,对照组中位时间为5(1,7)d,2组比较差异无统计学意义(P=0.619)。研究中未发现与奈妥匹坦帕洛诺司琼胶囊相关明显不良反应。结论全身放疗前应用奈妥匹坦帕洛诺司琼胶囊对消化道起保护作用,且耐受性良好,对造血干细胞移植时间无影响。Objective To explore the protective effect of netupitant/palonosetron(NEPA)on the digestive tract during total body irradiation before hematopoietic stem cell transplantation.Methods A retrospective analysis was performed on 73 cases of hematopoietic stem cell transplantation who received total body irradiation as a pretreatment regimen in Chengdu BOE Hospital from 2021.9 to 2024.6.The cases who took NEPA orally before total body irradiation were the observation group,and the cases who did not take NEPA orally before total body irradiation were the control group.The two groups were compared in terms of nausea,vomiting,parenteral nutrition,hematopoietic stem cell implantation time,and NEPA-related adverse reactions during treatment.The chi-square test and rank sum test were used for statistical comparison between the two groups.Results There were 39 patients(53%)in the observation group and 34 patients(47%)in the control group.In the observation group,15 patients had nausea at grade I,while in the control group,21 patients had nausea at grade I and 11 patients had nausea at gradeⅡ.In the observation group,6 patients had vomiting at grade I and 1 patient had vomiting at gradeⅡ,while in the control group,11 patients had vomiting at grade I,18 patients had vomiting at gradeⅡand 1 patient had vomiting at gradeⅢ.The difference between the two groups was statistically significant(P<0.001).One patient in the observation group received parenteral nutrition,while 7 patients in the control group received over-the-counter nutrition.The difference between the two groups was statistically significant(P=0.017).The median time from the end of systemic radiotherapy to the transfusion of hematopoietic stem cells was 5(1-8)days in the observation group and 5(1-7)days in the control group.There was no statistically significant difference between the two groups(P=0.619).No obvious adverse reactions related to NEPA were found in the study.Conclusion The use of NEPA before total body irradiation has a protective effect on the d

关 键 词：放疗 造血干细胞移植 恶心 呕吐 

分 类 号：R457.7[医药卫生—治疗学] R733[医药卫生—临床医学] R730.55