福沙匹坦联合5-HT3受体拮抗剂预防化疗相关性呕吐的临床观察

Clinical Observation of Fosaprepitant Combined with 5-HT3 Receptor Antagonist in the Prevention of Vomiting Induced by Chemotherapy

观察福沙匹坦联合5-HT3受体拮抗剂方案预防化疗相关性呕吐的疗效和不良反应。采用的方法:选择60例经病理确诊的恶性肿瘤接受化疗的患者,随机分为2组,观察组30例,采用福沙匹坦、5-HT3受体拮抗剂(托烷司琼或格拉司琼)及地塞米松三联方案,对照组30例,采用5-HT3受体拮抗剂(托烷司琼或格拉司琼)、地塞米松二联方案。观察两种方案对两组患者抗肿瘤化疗后急性期(0-24h)及延迟期(24-120h)呕吐的预防情况并记录两组患者不良反应发生情况。取得以下结果:在入组的60例患者中,福沙匹坦联合5-HT3受体拮抗剂(托烷司琼或格拉司琼)、地塞米松三联方案组和5-HT3受体拮抗剂(托烷司琼或格拉司琼)、地塞米松二联方案组对急性期呕吐的完全缓解率分别为76.7%和56.7%,有效控制率分别为90%和80%。对延迟期呕吐的完全缓解率分别为70%和43.3%,有效控制率分别为86.7%和70%。两组止吐药物相关不良反应无明显差异。可以认为,福沙匹坦联合5-HT3受体拮抗剂(托烷司琼或格拉司琼)、地塞米松三联方案对化疗引起的急性及延迟性呕吐疗效确切,为提高化疗患者生活质量提供了较好的选择方案,治疗的依从性好,值得推广。

Objective:to observe clinical efficacy and ADR of fosaprepitant combined with 5-HT3 receptor antagonist(tropisetron,granisetron)in the prevention of vomiting induced by chemotherapy.Methods:sixty patients with malignant tumor were randomly assigned to observation group(n=30)(fosaprepitant+tropisetron or granisetron+dexamethasone)and control group(n=30)(tropisetron or granisetron+dexamethasone).The effect and adverse reaction of two groups in acute phase(0-24h)and delay period(24-120h)on preventing vomiting were observed.Results:among 60 patients who achieved the assessment of clinical response,the complete response rates of acute vomiting by fosaprepitant combined with tropisetron or granisetron vs tropisetron or granisetron were 74.6%vs 57.6%,the control rate as 91.5%vs 81.4%,respectively(P<0.05);the complete response rate of delayed vomiting was 69.5%vs 42.4%,and the control rate as 86.4%vs 71.2%(P<0.05).There was no statistical significance in the incidence of ADR(P>0.05).Conclusions:Fosaprepitant combined with tropisetron or granisetron regimen is effective for vomiting induced by chemotherapy.This combination can improve the quality of life and the compliance of patient with chemotherapy.