阿瑞匹坦预防顺铂化疗所致恶心和呕吐的疗效分析

Efficacy of aprepitant in the prevention of cisplatin-induced nausea and vomiting

目的：为明确阿瑞匹坦在预防含顺铂的化疗方案所致的化疗相关性恶心呕吐的临床疗效。方法：选取我院2014年1月1日–2014年10月1日接受含顺铂（75 mg·m^-2）化疗方案的患者100例，接受阿瑞匹坦、5-HT3受体拮抗剂和地塞米松的患者为阿瑞匹坦组，同期使用5-HT3受体拮抗剂和地塞米松的患者为对照组，观察两组患者急性期（第1天）、延迟期（第2~5天）完全有效率（CR）及化疗期间（5 d）无严重恶心呕吐的发生率。结果：阿瑞匹坦组与对照组治疗急性呕吐的CR分别为70%和54%（P=0.149）；而治疗迟发性呕吐两组有效率分别为78%和46%（P=0.002），阿瑞匹坦组显著优于对照组。化疗期间阿瑞匹坦组与对照组患者无严重恶心呕吐的发生率分别为86%、62%（P=0.012），阿瑞匹坦组优于对照组。两组止吐药物相关不良反应无明显差异。结论：阿瑞匹坦三联方案在预防顺铂诱发恶心和呕吐的疗效及耐受性方面表现良好，为提高患者生活质量提供了较好的选择方式。

Objective：To observe the efifcacy of aprepitant in the prevention of the acute and delayed nausea and vomiting induced by cisplatin. Methods： A total of 100 cancer patients who received cisplatin （75 mg·m-2） in our hospital from January 1, 2014 to October 1, 2014 were enrolled. The antiemetic regimen for aprepitant group consisted of aprepitant, 5-HT3 receptor antagonist and dexamethasone;regimen for control group was 5-HT3 receptor antagonist and dexamethasone. The primary endpoints were the percentage of patients with a complete response （CR：no nausea and no salvage treatment） during the acute phase （day 1） and the delayed phase （days 2–5）. The secondary endpoint was the percentage of patients without severe nausea during the entire study period （5 days） with chemotherapy. Results： There was no statistical differences in CR rates of acute phase between two groups （CR：70%vs 54%, P=0.149）. The efifcacy of aprepitant group was better than that of control group in delayed phase （CR：78%vs 46%, P=0.002）. The percentages of patients with no severe nausea during the entire study period in aprepitant group and control group were 86%and 62%（P=0.012）, respectively. There were not signiifcant differences between two groups in respect of adverse reactions. Conclusion： Due to the good efifcacy and safety, the triple therapy containing aprepitant can be recommended for the prevention of cisplatin-induced nausea and vomiting.