格拉司琼预防胃癌化疗引起恶心呕吐的临床研究

Clinical Study on Granisetron in the Prophylaxis of Nausea and Vomiting Iduced by Chemotherapeutic Agents of Gastric Cancer

目的 :观察格拉司琼注射剂预防顺铂引起的急性及延迟性恶心呕吐的作用和毒副反应 ,并与恩丹西酮比较。方法 :采用随机自身对照方法 ,将 48例接受联合化疗 (含顺铂 )的胃癌患者随机分为A、B两组 ,均接受 2个周期相同方案的化疗。A组第 1周期用格拉司琼 ,第 2周期用恩丹西酮止吐 ;B组第 1周期用恩丹西酮 ,第 2周期用格拉司琼止吐。观察化疗后 2 4小时 (急性 )及 5日内 (延迟性 )恶心呕吐发生的情况。结果 :在化疗后 0h～ 6h ,格拉司琼对恶心的控制率与恩丹西酮相似 ,但第 1天、第 2天、第 3天格拉司琼对恶心的有效率 ( 62 5 %、47 9%、41 7% )优于恩丹西酮 ( 41 7%、2 7 1%、2 2 9% ,P <0 0 5 ) ,提示格拉司琼作用时间较恩丹西酮长。格拉司琼控制呕吐的效果及所致毒副作用与恩丹西酮相似。结论 :格拉司琼能有效控制胃癌化疗所致的恶心呕吐 ,作用时间较恩丹西酮长 ,它的不良反应轻 。

Objective: To evaluate the efficacy and side effects of granisetron injection for the prophylaxis of nausea and vomiting induced by cisplatin,and compare them with those of Ondansetron.Methods:A randomized crossover trial was performed.48 patients treated by combined chemotherapy with cisplatin were radomly divided into two groups(group A and group B).Both two groups received two cycles of same chemotherapy regimen.Either Granisetron or Ondansetron was given alternatively to these two groups in the first and second cycle.The cases of the vomiting and the nausea of all the patients in the first 24h(acute vomiting/nausea) and the following 5 days(delayed vomiting/nausea) were obsered.Results:Granisetron was the same effective as Ondansetron in the control of vomiting.The effective rates to nausea treated by Granisetron in the first day,the second day,and the third day were 62.5%,47 9%,41.7%,respectively,significantly higher than those of treated by Ondansetron(41.7%,27.1%,22.9%,P<0 05),respectively,which may indicate that the reaction time of the Granisetron was longer than that of the Ondansetron.The effective rate of the Granisetron group was higher than that of the Ondansetron group.Conclusion:Granisetron was effective in controlling nausea and emesis induced by chemotherapeutic agents for gastric cancer.The side effects induced by Granisetron were similar to those of induced by Ondansetron.