摘要
背景与目的:化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)可使癌症患者机体功能紊乱,甚至导致死亡。预防CINV对于接受致吐性化疗方案的患者至关重要。本研究旨在分析上海市三甲医院CINV的发生情况及处理方式,探讨与CINV相关的危险因素,以期进一步改善CINV管理。方法:选取2022年10月—2022年12月在上海市16家三甲医院接受治疗的376例癌症患者作为研究对象,采用问卷调查的方式开展横断面研究。使用单因素和多因素logistic回归模型分析CINV的影响因素。结果:2022年上海市CINV管理与指南符合率较5年前有显著改善。对于接受高致吐风险化疗方案的患者,指南符合率从21.6%提升至67.0%。对于接受中致吐风险化疗方案的患者,神经激肽-1(neurokinin-1,NK-1)受体抑制剂的使用并不能显著降低CINV的发生率。多因素分析显示,化疗方案是CINV发生的唯一独立危险因素(P<0.05)。结论:化疗方案是影响CINV发生的独立危险因素,临床实践中应优先关注药物本身的致吐风险,做好风险评估,严格遵循指南,从而最大化地控制CINV。
Background and purpose:Chemotherapy-induced nausea and vomiting(CINV)can cause severe damage to body functions and even lead to death.The prevention of CINV is critically important in patients receiving emetogenic chemotherapy regimen.This study aimed to investigate the prevalence and treatment of CINV in Grade-A tertiary hospitals in Shanghai and explore risk factors of CINV to improve its management.Methods:The clinical data of 376 cancer patients in Grade-A tertiary hospitals in Shanghai from October 2022 to December 2022 were collected retrospectively.The questionnaire was used to conduct a cross-sectional study.The univariate and multivariable logistic regression models were used to evaluate the influencing factors of CINV.Results:The management and coincidence of the guideline in 2022 significantly improved compared to five years ago.For patients receiving high-emetic-risk chemotherapy regimen,the coincidence of the guideline increased from 21.6%to 67.0%.For patients receiving moderate-emetic-risk chemotherapy regimen,the neurokinin-1(NK-1)receptor antagonist was not significantly associated with CINV.Multivariable analysis showed that the chemotherapy regimen was the only risk factor for CINV during the whole period(P<0.05).Conclusion:The chemotherapy regimen is the main risk factor for CINV.To control CINV better,clinical practitioners should focus on the intrinsic risk of chemotherapy regimens preferentially,estimate the risk and adhere better to guidelines.
作者
曾铖
金奕滋
李婷
章真
梁晓华
唐曦
刘天舒
李琦
沈赞
姜斌
王理伟
张俊
陈思宇
周彩存
高勇
臧远胜
李恒宇
董宇超
湛先保
钟薏
刘苓霜
秦悦农
胡夕春
张剑
ZENG Cheng;JIN Yizi;LI Ting;ZHANG Zhen;LIANG Xiaohua;TANG Xi;LIU Tianshu;LI Qi;SHEN Zan;JIANG Bin;WANG Liwei;ZHANG Jun;CHEN Siyu;ZHOU Caicun;GAO Yong;ZANG Yuansheng;LI Hengyu;DONG Yuchao;ZHAN Xianbao;ZHONG Yi;LIU Lingshuang;QIN Yuenong;HU Xichun;ZHANG Jian(Department of Medical Oncology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;PhaseⅠClinical Trial Center,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Radiation Oncology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai Key Laboratory of Radiation Oncology,Shanghai Clinical Research Center for Radiation Oncology,Shanghai 200032,China;Department of Oncology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Oncology,Huadong Hospital,Fudan University,Shanghai 200040,China;Department of Medical Oncology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Oncology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China;Department of Oncology,Shanghai Sixth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China;Department of Oncology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201999,China;Department of Oncology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Oncology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Oncology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Medical Oncology,Shanghai Pulmonary Hospital,Tongji University,Shanghai 200433,China;Department of Oncology,Shanghai East Hospital,School of Medicine of Tongji University,Shanghai 200120,China;Department of Medical Oncology,The Second Affiliated Hospital of Naval Medical University,Shanghai 200070,China;Department of Throat and Breast,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Oncology,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Oncology,Shanghai TCM-integrated Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China;Department of Oncology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Breast Department of Integrated Traditional Chinese and Western Medicine,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2023年第11期1009-1017,共9页
China Oncology
关键词
化疗所致恶心呕吐
癌症
横断面研究
Chemotherapy-induced nausea and vomiting
Cancer
Cross-sectional study
