奥氮平在乳腺癌联合治疗方案中辅助化疗所致恶心呕吐的疗效观察

Antiemetic Efficacy of Olanzapine in Neoadjuvant Chemotherapy with TEC Regimen on Breast Cancer

目的奥氮平在乳腺癌方案新辅助化疗所致恶心呕吐的疗效观察。方法 96例乳腺癌患者被随机分为治疗组(48例)及对照组(48例),治疗组和对照组均在化疗前30min静脉滴注托烷司琼4mg及静脉注射地塞米松10mg,治疗组自化疗前24h晚上开始口服奥氮平5mg,连续服用3d,第1个化疗周期结束后评价止吐效果。结果治疗组恶心呕吐的总缓解率(87.50%)明显优于对照组(58.33%),差异具有显著统计学意义(P<0.01)。治疗组的急性恶心呕吐的发生率(6.25%)和迟发性恶心呕吐的发生率(10.41%)均明显低于对照组(27.08%和33.33%),差异有统计学意义(P<0.05)。结论与托烷司琼联合地塞米松相比,奥氮平联合托烷司琼和地塞米松对预防、控制乳腺癌TEC方案新辅助化疗后的急性恶心呕吐和延迟性恶心呕吐的效果较佳。

Objective To observe the antiemetic efficacy of olanzapine in neoadjuvant chemotherapy with TEC regimen on breast cancer.Methods Ninety-six cases of breast cancer patients were randomly and equally divided into treatment group and control group.Both groups were given intravenously 4mg tropisetron and 10 mg dexamethasone 30 min before chemotherapy.In the treatment group,5mg olanzapine was orally administered for three consecutive days from 24 hprior to chemotherapy,and the antiemetic efficacy was evaluated at the end of the first chemotherapy cycle.Results The total remission rate of nausea and vomiting in the treatment group（87.50%）was significantly higher than that in the control group（58.33%）,and the difference was of statistical significance（P〈0.01）.The incidence of acute nausea and vomiting（6.25%）and delayed nausea and vomiting（10.41%）in the treatment group was lower than that in the control group（27.08%and 33.33%）.The difference between these two groups was also statistically significant（P〈0.05）.Conclusion Compared to tropisetron combined with dexamethasone,olanzapine combined with tropisetron and dexamethasone shows better efficacy in preventing and controlling neoadjuvant chemotherapy-induced acute nausea and vomiting with TEC regimen on breast cancer.