阿瑞匹坦用于小细胞肺癌EP方案化疗预防性止吐的临床疗效评价

Clinical research on aprepitant for the prevention of nausea and vomiting due to EP regimen chemotherapy in small-cell lung cancer patients

目的评价阿瑞匹坦在小细胞肺癌依托泊苷联合顺泊(EP)方案化疗中,对急性期及迟发性吐的疗效和安全性。方法选取48例小细胞肺癌患者,给予依托泊苷联合顺铂的EP方案化疗,随机分为实验组及对照组,每组各24例。对照组患者接受地塞米松、5-HT3受体拮抗剂托烷司琼预防止吐,实验组在对照组的基础上联合使用阿瑞匹坦预防止吐。完成1个周期化疗后,评估两组患者化疗后的急性、迟发性恶心呕吐情况及不良反应。结果 48例患者均按时完成1个周期的EP方案化疗,实验组和对照组急性恶心、呕吐完全缓解率(CR)差异无统计学意义(P>0.05),有效率(RR)差异无统计学意义(P>0.05);实验组和对照组迟发性恶心呕吐CR差异均无统计学意义(P<0.05),RR差异有统计学意义(P<0.05);两组患者轻度不良反应(乏力、呃逆、头晕、腹胀、便秘)比较,差异无统计学差异(P>0.05)。结论阿瑞匹坦联合地塞米松、托烷司琼预防治疗小细胞肺癌EP方案化疗中引起的急性及迟发性恶心呕吐安全性高,尤其对迟发性CINV有确切疗效,可在临床推广使用。

Objective To observe the acute and delayed antiemetic effects and safety of aprepitant for the prevention of EP regimen chemotherapy-induced nausea and vomiting in small-cell lung cancer patients. Methods 48 patients with small-cell lung cancer were randomly divided into the experimental group and control group, 24 cases in each group. All the patients in the two groups received EP regimen chemotherapy （etoposide and cisplatin）. The antiemetic regimen for control group was 5-HT3 receptor antagonist tropisetron and dexamethasone. The regimen for experimental group consisted of aprepitant, tropisetron and dexamethasone. The acute and delayed antiemetic effects and adverse effects were evaluated after 1 cycle chemotherapy. Results All the 48 patients completed 1 cycle chemotherapy. The CR rates of acute antiemetic effect in experimental group and control group were 37.5% and 33.3%. There was no significant difference between the two groups （P〉0.05）. The RR rates of acute antiemetic effect in experimental group and control group were 87.5% and 79.2%. There was no difference between the two groups （P〉0.05）. The CR rates of delayed antiemetic effect in experimental group and control group were 45.8~/~ and 16.7%. There were statistical difference between the two groups （P〈0.05）. The RR rates of delayed antiemetic effect in experimental group and control group were 79.2% and 45.8%. There was no difference between the two groups （P〉0.05）. The adverse effects mainly included dizziness, fatigue, hiccups, bloating and constipation. There was no statistical difference between the two groups. Conclusion Aprepitant combined with tropisetron and dexamethasone has better antiemetic effects on the prevention of nausea and vomiting due to etoposide and cisplatin chemotherapy in small-cell lung cancer patients.