阿瑞吡坦联合方案预防化疗相关恶心呕吐的临床效果分析

Efficacy of Aprepitant in Preventing CINV

目的探讨阿瑞吡坦联合托烷司琼、地塞米松方案预防治疗化疗相关恶心呕吐(CNIV)的临床疗效。方法回顾性分析2016年8月至2019年12月我科使用含高度致吐药顺铂、阿霉素方案化疗的肿瘤患者,使用阿瑞吡坦联合方案对其早、晚期阶段及整体阶段的化疗相关呕吐的临床效果。结果阿瑞吡坦组和对照组在急性呕吐观察期(0~24 h)、延迟性呕吐观察期(24~120 h)及整体观察期的有效控制率别为76.7%vs73.3%、83.3%vs60.0%及80.0%vs66.7%;两组发生呃逆不良反应差异以阿瑞吡坦组较为明显(P<0.05),而头痛、便秘、疲乏、消化不良及皮疹等不良反应则差异无统计学意义(P>0.05);两组生活质量评估亦有明显差异(P<0.05)。结论阿瑞吡坦联合托烷司琼、地塞米松方案较不联合阿瑞吡坦方案可有效改善CINV,尤其对于延迟性呕吐的效果明显,提高其化疗依从性和生活质量,且不良反应轻,耐受性良好。

Objective Chemotherapy induced nausea and vomiting(CINV)has a profound effect on patients.In recent years,there have been new antiemetic drugs,such as aprepitant.We review the curative effect of aprepitant with tropisetron and dexamethasone for prevention of nausea and vomiting in patients receiving Cisplatin or Adriamycin chemotherapy.Methods Observation is divided into three stages.Whole study phase(0~120 h)after chemotherapy administration,acute phases(0~24 h),and delayed phase(24~120 h).The primary endpoints were complete response(CR)and partial response(PR)during the three different study phase.Re・suits In the whole study phase,80.0%of observation group patients achieved CR and PR,which in acute phases and delayed phases were 76.7%and 83.3%respectively.The results are all higher than the control group.There was no significant difference in drug adverse effect,except for hiccup(P>0.05).And two groups had distinct difference in function living index-emesis.Conclusion Aprepitant with tropisetron and dexamethasone prevented effectively CNIV for patients receiving Cisplatin or Adriamycin chemotherapy,especially in delayed phases.This combination could improve the quality of life and the compliance of patient with chemotherapy.