格拉司琼联合地塞米松预防化疗致恶心呕吐的研究

The Research of Granisetron Combined with Dexamethasone in Preventing Nausea and Emesis Induced by Chemotherapy with Cisplation

目的观察格拉司琼与地塞米松联用预防含顺铂方案的联合化疗所导致的恶心、呕吐及其他不良反应,并和单使用格拉司琼比较。方法采用随机、交叉、自身对照法,将50例接受含顺铂30mg(/m2·d)×3d的联合化疗的恶性肿瘤患者,随机分为甲、乙两组。甲组第1周期用格拉司琼,第2周期用格拉司琼加地塞米松;乙组第1周期用格拉司琼加地塞米松,第2周用格拉司琼。止吐方案:格拉司琼3mg,静注,第1～3天。地塞米松10mg,静推,第1～3天。结果格拉司琼加地塞米松(联合组)第1～6天无恶心和轻度恶心发生率均高于单用格拉司琼(单用组),其中第2～4和第6天差异有显著性(P<0.05)。格拉司琼加地塞米松(联合组)第1～6天呕吐完全控制率(CR率)和有效控制率(CR+PR)均高于单用格拉司琼(单用组),其中第3、4天差异有显著性(P<0.05)。结论地塞米松能增强格拉司琼对含顺铂化疗方案化疗所导致的恶心、呕吐的控制,可作为预防和控制含顺铂化疗方案联合化疗所导致恶心、呕吐的一线治疗。

Objective To observe the effect of granisetron combined with dexamethasone in preventing nausea, emesis and other adverse ef- fect induced by cisplatin regimen,and compare granisetron plus dexamethasone with granlsetron alone according to the antiemetic effect. Methods Fifty patients with cancer received cisplatin chemotherapy[DDP 30mg/ （m^2·d） ×3d] were divided randomly into 2 groups. Arm A received granisetron at the first cycle,and granisetron combined with dexamethasone at the second cycle. Arm B just received the contrary antiemetic regimen. The antiemetic scheme was granisetron 3 mg i.v. on day 1 to day 3 and dexamethasone 10 mg i.v. on day 1 to day 3. Resuits The incidence of nausea [None（nausea does not occur）and Mild（slight nausea but no disruption to daily activities）] in granisetron plus dexamethasone group was above the granisetron alone group on day 1 to day 6,and significant difference on day 2 to day 4 and day 6（P〈 0.05）. The complete（CR） and effective（CR ＋ PR） control rates of emesis in granisetron plus dexamethasone group were also above the granisetron alone group on day 1 to day 6,and significant difference on day 3 and day 4（P〈 0.05）. Conclusion Dexamethasone enhances granisetron of the control of nausea and emesis induced by chemotherapy with cisplation. Granisetron combined with dexamethasone could be of choice for the prevention and control of nausea and emesis associated with cisplatin.