阿瑞匹坦用于乳腺癌患者化疗的止吐效果观察

Efficacy of aprepitant in preventing chemotherapy-induced nausea and vomiting in patients with breast cancer

目的观察分析阿瑞匹坦用于乳腺癌患者化疗的止吐效果及安全性。方法选取我院经病理确诊的68例初诊化疗的乳腺癌患者,随机分为试验组及对照组。试验组34例,给予阿瑞匹坦联合托烷司琼、地塞米松;对照组给予安慰剂、格拉司琼、地塞米松,用药剂量及用法与试验组相同。观察两种治疗方案对化疗所致恶心、呕吐的疗效。结果 68例患者均纳入分析,阿瑞匹坦组患者完全缓解率明显优于对照组(61.8%vs.31.3%,P=0.029);阿瑞匹坦组与对照组的急性呕吐完全缓解率分别为85.3%和67.6%(P=0.086),呈降低趋势,但差异无统计学意义;阿瑞匹坦组迟发性呕吐的完全缓解率明显高于对照组(70.6%vs.44.1%,P=0.027),迟发性呕吐的发生率明显低于对照组(5.9%vs.29.4%,P=0.011)。本研究中未观察到阿瑞匹坦相关中重度不良反应,药物安全性良好。结论阿瑞匹坦对于乳腺癌化疗患者止吐效果良好,在迟发性呕吐的缓解方面尤其突出,且不良反应较轻,患者可耐受。

Objective To observe and analyze the efficacy and safety of aprepitant in preventing chemotherapy-induced nausea and vomiting in patients with breast cancer.Methods A total of 68 patients with breast cancer were randomly divided into two groups：treatment group（n = 34） and control group（n = 34）.Treatment group was treated with aprepitant combined with tropisetron and dexamethasone;control group was given placebo granisetron and dexamethasone,the dosage and usage being the same as the treatment group.The efficacy of the two therapeutic schemes in preventing chemotherapy-induced nausea and vomiting was observed.Results All 68 patients were included for analysis.The overall complete response rate of treatment group was higher than that of control group（61.8%vs.31.3%,P=0.029）.The overall complete response rate of acute vomiting in treatment group and control group was 85.3%and67.6%（P = 0.086）,showing a decreasing trend,but the difference was not statistically significant.The overall complete response rate of delayed vomiting of treatment group was significantly higher than that of control group（70.6%vs.44.1%,P = 0.027）,and the incidence of delayed vomiting was significantly lower than that of control group（5.9%vs.29.4%,P =0.011）.No aprepitant-related severe adverse reaction were observed in this study,which showed that the drug was safe.Conclusion Aprepitant is safe and effective in preventing chemotherapy-induced nausea and vomiting for patients with breast cancer,especially in the delayed phase,and the adverse reaction is mild and tolerable.