奥氮平对乳腺癌患者蒽环类药物化疗止吐效果研究

The effect of olanzapine on antiemetic effects of anthracycline chemotherapy in breast cancer patients

目的探讨阿瑞匹坦、盐酸帕洛诺司琼、地塞米松三联止吐方案联合或不联合奥氮平对接受蒽环类药物治疗的乳腺癌患者的止吐效果。方法选取自2017年3月至2020年3月在北部战区总医院首次接受阿霉素+环磷酰胺/表柔比星+环磷酰胺(AC/EC)化疗方案治疗的49例乳腺癌患者为研究对象。根据止吐方案将患者分为常规组(n=32)与观察组(n=17)。观察组接受奥氮平、阿瑞匹坦、盐酸帕洛诺司琼、地塞米松四联止吐方案;常规组接受阿瑞匹坦、盐酸帕洛诺司琼、地塞米松三联止吐方案。比较两组患者在整体期、急性期及延迟期的恶心呕吐发生率、完全缓解率及止吐药物不良反应发生率。结果两组患者在急性期、延迟期和整体期的恶心呕吐发生率比较,差异无统计学意义(P>0.05)。观察组患者在急性期、延迟期和整体期的化疗后恶心呕吐的完全缓解率均高于常规组,差异有统计学意义(P<0.05)。两组患者嗜睡、失眠、头痛、便秘、疲劳、厌食的不良反应发生率比较,差异无统计学意义(P>0.05)。结论奥氮平联合阿瑞匹坦、盐酸帕洛诺司琼、地塞米松的止吐方案可提高患者恶心呕吐的完全缓解率,且药物安全性良好,有助于改善患者化疗后生活质量,提高治疗依从性。

Objective To evaluate the antiemetic effect of a three-drug antiemetic regimen of aprepitant, palonosetron hydrochloride, and dexamethasone with or without olanzapine on breast cancer patients receiving anthracyclines.Methods A retrospective analysis was performed on 49 breast cancer patients who received their first adriamycin+cyclophosphamide/epirubicin+cyclophosphamide(AC/EC)chemotherapy regimen in the General Hospital of Northern Theater Command from March 2017 to March 2020.Patients were divided into routine group(n=32)and observation group(n=17)according to the antiemetic scheme.The observation group received a four-drug antiemetic regimen of olanzapine, aprepitant, palonosetron hydrochloride, and dexamethasone.The routine group received a three-drug antiemetic regimen of aprepitant, palonosetron hydrochloride, and dexamethasone.The incidence of nausea and vomiting, complete remission rate and the incidence of adverse reactions of antiemetic drugs in the whole period, acute period and delayed period were compared between the two groups.Results There was no statistical significance in the incidence of nausea and vomiting between two groups in the acute stage, delay stage and overall stage(P>0.05).The complete remission rate of nausea and vomiting after chemotherapy in the observation group was higher than that in the conventional group in the acute phase, delay phase and overall phase, with statistical significance(P<0.05).There was no statistical significance in the incidence of somnolence, insomnia, headache, constipation, fatigue and anorexia between two groups(P>0.05).Conclusion The antiemetics of olanzapine combined with aprepitant, palonosetron hydrochloride and dexamethasone can improve the complete remission rate of nausea and vomiting in patients, and the drug safety is good, which is helpful to improve the quality of life of patients after chemotherapy and improve treatment compliance.