多通路阻断乳腺癌化疗所致恶心呕吐的疗效观察

The observation of multipathway blocking the effect of nausea and vomiting induced by chemotherapy in breast cancer

目的:观察含阿瑞匹坦的三联方案在乳腺癌化疗止吐的疗效以及不良反应。方法:将术后病理诊断为乳腺癌并进行首次化疗的共108例患者随机分为2组:试验组54例和对照组54例。其中试验组给予含阿瑞匹坦的方案(阿瑞匹坦、帕洛诺司琼和地塞米松)止吐,对照组给予标准治疗方案(帕洛诺司琼和地塞米松)止吐,观察两组化疗后诱发恶心、呕吐情况以及可能出现的并发症。结果:试验组在急性期(90.7%vs75.9%,P<0.05)和延迟期(81.5%vs 63.0%,P<0.05)对恶心呕吐控制率均优于对照组。在试验组中,对延迟期的止吐效果更显著,延迟期止吐有效率净提高18.5%,急性期止吐有效率净提高14.8%。2组不良反应情况比较除疲劳(P<0.05)外差异均无统计学意义。结论:含阿瑞匹坦的多通路阻断呕吐反射可有效提高乳腺癌术后辅助化疗所致恶心呕吐的疗效,耐受性良好,可作为乳腺癌术后辅助化疗的止吐方案。

Objective： To investigate the antiemetic effect of triple therapy with aprepitant in chemotherapy of breast cancer and the observation of adverse reactions. Methods： The data of 108 patients were all passed the postoperative pathological diagnosis of breast cancer and now had their first time chemotherapy. We randomly divided them into 2 groups,54 cases for experimental group and 54 cases for the control group. The experimental group used therapeutic regimen with aprepitant（ aprepitant,palonosetron and dexamethasone） while the control group was given standard treatment（ palonosetron and dexamethasone）. And to observe the nausea,vomiting and other possible complications induced by chemotherapy. Results： The remission rate of nausea and vomiting induced by chemotherapy in the experimental group was significantly better than that in the control group both the acute stage（ 90. 7% vs 75. 9%,P〈 0. 05） and delay stage（ 81. 5% vs 63. 0%,P 〈0. 05）. There were 18. 5% in net increase in the delay stage and14. 8% in the acute stage. And the adverse reactions in the two group were not statistically significant except the fatigue（ P〈 0. 05）. Conclusion： The multipath blocking the reflex of vomiting in aprepitant as a good performance in the efficacy and tolerability of vomiting induced by chemotherapy of breast cancer patients with high risk of vomiting.Therefore,it could be used as an adjuvant chemotherapy antiemetic regimen for breast cancer patients after doing the surgery.