帕洛诺司琼不同给药频次预防大剂量顺铂化疗致胃肠道反应的临床观察

Clinical observation on various frequency of palonosetron for preventing gastrointestinal adverse reaction induced by high-dosage cisplatin chemotherapy

目的探讨帕洛诺司琼不同给药频次预防大剂量顺铂化疗致胃肠道反应的临床疗效。方法上海市奉贤区中心医院2010年4月—2014年1月收治的行大剂量顺铂化疗的恶性肿瘤患者,随机分为对照组(42例)和治疗组(42例)。对照组化疗第1天治疗前30 min静脉点滴盐酸帕洛诺司琼注射液0.25 mg/次;治疗组于化疗第1、3、5天治疗前30 min静脉点滴盐酸帕洛诺司琼注射液0.25 mg/次。所有患者仅观察1个化疗周期。比较两组患者呕吐、恶心、食欲减退的发生情况。结果对照组急性期呕吐有效控制率为78.57%,治疗组为83.33%,两组比较差异无统计学意义;延迟期对照组呕吐有效控制率为52.38%,治疗组为61.90%,两组比较差异有统计学意义(P<0.01)。治疗后,急性期对照组恶心有效率为61.90%;治疗组有效率为76.19%;延迟期对照组恶心有效率为52.38%,治疗组为66.67%,两组比较差异有统计学意义(P<0.01)。急性期对照组食欲减退有效控制率为88.10%,治疗组为92.86%;延迟期对照组有效控制率为85.71%,治疗组为90.48%,两组比较差异无统计学意义。两组不良反应发生率比较差异无统计学意义。结论对大剂量顺铂化疗致胃肠道反应可适当增加盐酸帕洛诺司琼用药频次进行预防,但应警惕增加不良反应的风险。

objective To observe the clinical effects on various frequency of palonosetron for preventing gastrointestinal adverse reaction induced by high-dosage cisplatin chemotherapy. Methods The patients （84 cases） diagnosed as malignant tumor who were accepted high-dosage cisplatin chemotherapy in Shanghai Fengxian District Central Hospital from April 2010 to January 2014 were randomly divided into treatment （42 cases） and control （42 cases） groups. Patients in the control group were iv administered with Palonosetron Injection 0.25 mg/time 30 min before the treatment on day 1 of chemotherapy. Patients in the treatment group were iv administered with Palonosetron Injection 0.25 mg/time 30 min before the treatment on days 1, 3, and 5 of chemotherapy. All the patients were observed for one cycle of chemotherapy. Occurrence situations of vomiting, nausea, and loss of appetite were compared. Results In the acute phase, vomiting control efficiency in the control group was 78.57% and 83.33% in the treatment group, while the difference was no statistically significant between the two groups. In the delay phase, vomiting control efficiency in the control group was 52.38%and 61.90%in the treatment group, with the significant difference between the two groups （P〈0.01）. After the treatment, in the acute phase, the nausea efficiency in the control group was 61.90%and 76.19%in the treatment group. In delay phase, the nausea efficiency in the control group was 52.38%and 66.67%in the treatment group, with the significant difference between the two groups （P〈0.01）. In the acute phase, the loss of appetite control efficiency in the control group was 88.10%and 92.86%in the treatment group . In the delay phase, the loss of appetite control efficiency in control group was 85.71%and 90.48%in the treatment group, while the difference was no statistically significant between the two groups. Conclusion The frequency of palonosetron could be appropriately increased for preventing gastrointestinal adverse reaction induced by high-dosage cisplatin chemotherapy, but the increased risk of adverse reactions should be alerted.