甲泼尼龙合用昂丹司琼防治顺铂引起的急性、迟发性恶心呕吐  

Methylprednisolone plus ondansetron for the control of acute and delayed cisplatin-induced emesis

作　　者：张永强[1] 武晓楠[1] 刘焱[1] 陈岩[1] 伍建宇[1] 李文举[1] 程刚[1] 周美珍[1] 

机构地区：[1]北京医院肿瘤科,北京100730

出　　处：《中国癌症杂志》2003年第3期237-239,共3页China Oncology

摘　　要：目的 :观察甲泼尼龙 (methylprednisolone,甲强龙 )合用昂丹司琼 (恩丹西酮 )治疗以顺铂为主联合化疗引起的呕吐的效果和安全性。方法 :采用随机自身交叉对照方法。 47例患者中 2 3例第 1周期先用甲泼尼龙 80mg和昂丹司琼 8mg ,第 2周期单用昂丹司琼 8mg ;2 4例第 1周期单用昂丹司琼 8mg ,第 2周期用甲泼尼龙 80mg和昂丹司琼 8mg。以上药物均于化疗前 2 0分钟静脉给予 ,每天 1次。每一患者两周化疗药及其剂量相同 (其中顺铂80mg/m2 ) ,止吐药使用天数相同 (一般 2～ 3天 )。结果 :甲泼尼龙合用昂丹司琼和单用昂丹司琼治疗急性呕吐的有效率分别为 93 6 %和 70 2 % (P <0 0 1 ) ,治疗迟发性呕吐的有效率分别为 85 1 %和 65 9% (P <0 0 5) ;对由患者按线性分级计分所得的恶心、食欲、精神状态的疗效合用组明显优于单用组 (P <0 0 1 )。两组治疗不良反应发生率相似且合用组程度较轻。结论 :甲泼尼龙能加强昂丹司琼治疗由大剂量顺铂引起的急性和迟发性呕吐的止吐疗效 ,且能使患者恶心、食欲、精神状态得到明显改善 ,副作用较轻 。Purpose:To study the efficacy and safety of combination of methylprednisolone (MP) and ondansetron (OND) in the prevention of acute and delayed nausea and emesis induced by cisplatin base chemotherapy. Methods:This was a randomized, self cross over study. 47 patients receiving cisplatin based chemotherapy were randomized to enter one of the two following groups:Group 1:the combination of 80mg MP and 8 mg OND were iv injected to the patients before the first cycle of chemotherapy and then 8 mg OND was iv injected to the same patients before the second cycle of chemotherapy (23 cases); Group 2:8mg OND was iv injected to the patients before the first cycle of chemotherapy and then the combination of 80 mg MP and 8mg OND were iv injected to the same patients before the second cycle of chemotherapy (24 cases). The dosage of chemotheraputic agents and the times of anti emesis agents were the same in the two different cycles of chemotherapy for each patient.Results:The complete and partial control of the acute emesis were significantly superior in the combination of MP and OND than in the OND alone(93.6% versus 70.2%, P <0 01); the complete and partial control of the delayed emesis on the worst day between days 2 and 6 were also significantly superior in the combination of MP and OND than in the OND alone (85.1% versus 65.9%, P <0 05). The patients' quality of life during the period of chemotherapy showed a statistically significant difference between the two different anti emesis treatments, which was obviously in favour of the first group. Both treatments were well tolerated. Conclusions:The study confirmed methylprednisolone can improve the efficacy of ondansetron in acute and delayed cisplatin induced emesis. [

关 键 词：甲泼尼龙 合用 昂丹司琼 防治 顺铂 急性 迟发性 恶心呕吐 

分 类 号：R730.53[医药卫生—肿瘤]