阿瑞匹坦预防阿霉素联合异环磷酰胺方案化疗后呕吐的临床观察

Clinical Observation of Aprepitant in the Antiemetic Treatment of Doxorubicin and Ifosfamide Regimen Induced Vomiting

[目的]观察阿瑞匹坦预防阿霉素联合异环磷酰胺(AI)方案化疗后呕吐的疗效及安全性。[方法]将接受AI化疗方案的80例骨肉瘤和软组织肉瘤患者随机分为两组,阿瑞匹坦组予以三联(阿瑞匹坦、帕诺洛司琼、地塞米松)止吐方案、对照组予以二联(帕洛诺司琼、地塞米松)止吐方案,比较两组患者恶心、呕吐的控制情况,同时观察阿瑞匹坦的不良反应。[结果 ]急性观察期,阿瑞匹坦组和对照组的完全缓解(complete response,CR)率分别为84.6%和63.4%(P<0.05);迟发性观察期,阿瑞匹坦组CR率高于对照组(74.4%vs.51.2%,P<0.05);在总观察期,阿瑞匹坦组CR率亦显著性高于对照组(69.2%vs.46.3%,P<0.05);而两组的不良反应发生率无明显差异(P>0.05)。[结论]阿瑞匹坦联合帕洛诺司琼及地塞米松能有效预防AI化疗方案引起的恶心呕吐,且不良反应可耐受。

[Objective] To evaluate the antiemetic efficiency and safety of aprepitant against AI regimen chemotherapy based on doxorubicin and ifosfamide induced vomiting. [Methods] Eighty patients confirmed malignant bone and soft tissue sarcoma and received AI regimen chemotherapy were divided into two groups randomly. The aprepitant group had a 3-drug combination（aprepitant,palonosetron and dexamethasone）. The control group received a 2-drug combination（palonosetron and dexamethasone）.The control of chemotherapy induced nausea and vomiting and the adverse effects were monitored. [Results] The incidence of complete response rate in aprepitant group and control group were 84.6% versus 63.4%（P〈 0.05） for acute phase. The complete control rate in aprepitant group were higher than that in control group（74.4% vs. 51.2%,P〈0.05）for delayed phase. The complete control rate in aprepitant group were also significantly higher than that in control group（69.2% vs. 46.3%,P〈0.05） for overall phase. Statistical analysis showed no difference on adverse effects of two groups. [Conclusions] Aprepitant,palonosetron and dexamethasone significantly prevent the AI regimen induce nausea and vomiting. The side effects of aprepitant can be tolerated and controlled.