四联止吐方案对接受高致吐性化疗方案治疗的乳腺癌患者的止吐效果研究

Clinical efficacy of aprepitant-quadruple antiemetic drugs in highly emetogenic chemotherapy of breast cancer

目的评估阿瑞匹坦、奥氮平、托烷司琼与地塞米松四联止吐方案对接受高致吐性化疗方案治疗的女性乳腺癌患者的止吐效果。方法选取2016年3月至2017年3月于郑州大学附属肿瘤医院乳腺科及肿瘤内科首次接受化疗的60例女性乳腺癌患者,所有患者均接受AC/EC方案化疗,按照随机数表法分为两组,各30例。试验组患者接受阿瑞匹坦、奥氮平、托烷司琼和地塞米松四联止吐方案;对照组接受托烷司琼和地塞米松二联止吐方案。比较两种方案的止吐效果。结果两组患者急性期恶心、呕吐发生率及完全缓解率比较,差异无统计学意义(P>0.05);试验组患者延迟期恶心、呕吐发生率低于对照组,延迟期及总恶心、呕吐完全缓解率优于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者均未观察到Ⅲ~Ⅳ级不良反应,试验组患者嗜睡发生率高于对照组,差异有统计学意义(P<0.05),两组其他不良反应发生率比较,差异无统计学意义(P>0.05)。结论四联止吐方案用于接受高致吐性化疗方案治疗的女性乳腺癌患者,可降低患者的恶心、呕吐发生率,缓解患者的恶心、呕吐症状,且不良反应发生率低,患者可耐受。

Objective To evaluate the efficacy and safety of aprepitant, olanzapine combined with tropisetron and dexamethasone quadruple drugs in women with breast cancer in AC / EC chemotherapy. Methods A total of 60 patients with breast cancer were randomly divided into two groups： trail group （30 cases） and control group （30 cases）. Trail group antiemetic drugs： aprepitant, olanzapine, tropisetron and dexamethasone ; control group drugs ： tropisetron and dexamethasone. Results There was no statistically significant difference between the two groups in the incidence of nausea and vomiting in the acute phase. However, there was a significant advantage of trail group in the delayed phase （ P 〈 0. 05 ）. There was no significant difference in CINV complete remission rate（CRR） between the two groups in the acute phase, but there was a significant advantage of trail group in the delayed and complete CINV CRR （ P 〈 0. 05 ）. No adverse effects of grade Ⅲ - Ⅳ were observed during treatment. The incidence of somnolence was higher in the trial group （ P 〈 0. 05 ）. The other adverse effects were no significant differences between the two groups. Conclusion The quadruple antlemetic drugs are safe and effective in preventing chemotherapy - induced nausea and vomiting for patients with breast cancer, and the adverse reaction is tolerable and mild.