呕必亭改进方案预防顺铂所致呕吐的临床观察

Single-dose Tropisetron for Prevention of Cisplatin-induced Emesis

目的：评价呕必亭１ 天给药预防含顺铂分次给药中度致呕的联合化疗所致呕吐的可行性，与枢丹比较，观察两药的止吐疗效和毒性。方法：４０ 例接受含顺铂２０ ～２５ｍｇ／ｍ２／日，连续３ 天的联合化疗患者，采用随机、交叉、自身对照方法，分别给予呕必亭５ｍｇ，静注，第１ 天；或枢丹８ｍｇ，静注，第１ ～３ 天。结果：对急性呕吐，呕必亭和枢丹有效率分别为９２５ ％ 和９５０％ ，完全控制率分别为９２５％ （３７／４０） 和８００％ （３２／４０） 。对延迟性恶心、呕吐（ 第２ ～５天） 完全控制率和有效率亦相近，差异无统计学意义（ Ｐ＞ ００５） 。两药的副作用均较轻微。结论：呕必亭５ｍｇ １ 天给药与枢丹８ｍｇ ３ 天给药止呕吐疗效相似。呕必亭１ 天给药方便且费用低，但仍需评价和发展使用方便、费用适宜且对延迟性恶心。

Purpose: To evaluate the feasibility of single dose of Tropisetron for prevention of fractionated Cisplatin combination chemotherapy induced emesis and compare the efficacy and toxicity of Tropisetron with Zudan (Ondansetron) Methods: Forty patients treated with combination chemotherapy based on Cisplatin 20～25 mg/m 2/d for three days were enrolled in a randomized, crossover study after use of single dose of Tropisetron 5mg i v and Ondansetron 8mg i v three times a day Results: The complete response of acute emesis was obtained in 92 5%(37/40) of the patients who received Tropisetron versus 80 0%(32/40) of the patients who received Ondansetron The overall response of acute emesis was 92 5%versus 95 0%( P >0 05) The overall response and complete response of delayed nausea and emesis were similar between these two groups ( P >0 05) Adverse effects were mild and well tolerated Conclusion: This study suggests that single dose of Tropisetron at 5mg i v is as effective as Ondansetron 8mg i v three times a day in the prevention of fractionated Cisplatin combination chemotherapy induced moderate emesis It warrants to evaluate and develop new convenient approach for effective control of delayed nausea and emesis with less cost