奥氮平替代阿瑞匹坦预防化疗诱发恶心呕吐的临床效果研究

Study on clinical effect of olanzapine instead of aprepitant in preventing chemotherapy-induced nausea and vomiting

目的探讨奥氮平和阿瑞匹坦对接受高致吐化疗方案(HEC)患者预防化疗诱发恶心呕吐(CINV)的安全性和有效性,探讨预防CINV更为经济的替代方案。方法选取2015年3月至2017年1月在该院肿瘤科病房接受顺铂或环磷酰胺联合表阿霉素化疗方案的患者115例作为研究对象,将其随机分为APD组(n=62)和OPD组(n=53),OPD组采用奥氮平联合帕洛诺司琼、地塞米松预防CINV,APD组采用阿瑞匹坦联合帕洛诺司琼、地塞米松预防CINV。比较2组治疗疗效,对奥氮平和阿瑞匹坦预防CINV的成本效益、恶心(0级和1级)控制率、无呕吐且无解救治疗的完全缓解(CR)等情况进行比较分析。结果2组患者无明显恶心(0级和1级)、CR率在急性期、延迟期和全程比较,差异均无统计学意义(P>0.05)。2组全程无明显的3、4级药物毒性反应。结论奥氮平可替代阿瑞匹坦作为接受HEC方案患者预防CINV的替代药物,值得临床推荐。

Objective To investigate the safety and effectiveness of olanzapine and aprepitant in preventing chemotherapy-induced nausea and vomiting(CINV)in the patients receiving highly emetogenic chemotherapy(HEC),and to explore more economical alternative scheme for preventing CINV.Methods One hundred and fifteen patients receiving cisplatin or cyclophosphamide combined with epirubicin chemotherapeutic scheme in the oncology department of the hospital from March 2015 to January 2017 were selected as the research subjects and randomly divided into the APD group(n=62)and OPD group(n=53).The OPD group used olanzapine combined with palonosetron and dexamethasone for preventing CINV,and the APD group adopted aprepitant combined with palonosetron and dexamethasone for preventing CINV.The efficacies were compared between the two groups,and the cost-effectiveness of olanzapine and aprepitant in preventing CINV,nausea(grade 0 and grade 1)control rate,complete remission(CR)without vomiting and no rescue treatment conducted the comparative analysis.Results The two groups had no significant nausea(grade 0 and grade 1),and the CR rate had no statistical difference during the acute stage,delayed stage and whole process between the two groups(P>0.05).There were no obvious grade 3 and grade 4 drug toxicity reactions in the two groups.Conclusion Olanzapine can replace aprepitant as an alternative drug for the prevention of CINV in the patients receiving HEC regimen,and it is worth recommending.