低致吐化疗药引发延迟性恶心呕吐的风险因素分析

Analysis of risk factors for delayed nausea and vomiting induced by low emetogenic chemotherapeutic drugs

目的:探讨低致吐化疗药物(low-emetic-risk chemotherapy,LEC)引发延迟性化疗相关恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)的风险因素,以帮助个体化止吐和止呕。方法:在2016年9月至2018年9月期间收治的接受LEC治疗的实体瘤患者。在患者接受LEC的第一个周期开始每天记录恶心、呕吐情况,连续记录5日,以描述CINV的每日发病情况。结果:共125名患者具有完善的信息记录,这些患者不同程度的延迟性CINV发生率为28.8%。使用多变量逻辑回归分析延迟CINV的风险因素,结果显示ECOG评分≥1、出现急性CINV和单日预防止吐被确定为延迟CINV的独立危险因素。结论:LEC引发延迟性恶心呕吐更常见于体力状态差、有急性CINV发生、仅接受单日预防止吐治疗的患者。对这些患者应根据其症状调整预防止吐方案。

Objective:To investigate the risk factors of delayed chemotherapy-induced nausea and vomiting(CINV) induced by low-emetogenic chemotherapeutic drugs(LEC) to help individuals with antiemetic and vomiting.Methods:Patients with solid tumors treated with LEC were enrolled between September 2016 and September 2018.Nausea and vomiting were recorded daily after the start of the first cycle of patients receiving LEC for 5 consecutive days to describe the daily incidence of CINV.Results:A total of 125 patients had a well-documented record of 28.8% of all patients with delayed CINV.Risk factors for delayed CINV were analyzed using multivariate logistic regression and the results showed that ECOG scores≥1,acute CINV,and single-day pre-prevention vomiting were identified as independent risk factors for delayed CINV.Conclusion:Delayed nausea and vomiting induced by LEC is more common in patients with poor physical status,acute CINV,and only one-day pretreatment to prevent vomiting.These patients should be adjusted for their pre-anti-septic regimen based on their symptoms.