Patterns of antiemetic prophylaxis for chemotherapy-induced nausea and vomiting in China

Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.

Evaluation of Adherence to Chemotherapy-Induced Nausea and Vomiting Guidelines. An Observational Study

Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiveness of prescribed antiemetics. Additionally, we also sought to explore barriers that hinder clinical practice guideline (CPG) implementation. Methods: One hundred fifty-five patients between the ages of 18 and 60 who were admitted to the haematology/oncology department/clinic to receive intravenous chemotherapy, either as in-patients or outpatients, were enrolled in a prospective observational study. Relevant patient demographic data, chemotherapy protocols and antiemetics were collected. Chemotherapies were classified according to their emetogenic potential. This information was used to assess whether the antiemetic prescribed matched the emetogenic risk of treatment. The analysis of outcomes was performed using the MASCC antiemetic assessment tool. Key Findings: The results showed that 95% of antiemetic prescription pre-chemotherapy regimens did not adhere to the guidelines. The findings were use of twice the recommended dose of granisetron (87.7%), overuse granisetron (16%) and metoclopramide (62.6%), and underuse dexamethasone (27%) and corticosteroid duplication (7.7%). With respect to post-chemotherapy antiemetic prescriptions, 91% of prescriptions were not adherent to guidelines, with overuse of granisetron (81.9%) and metoclpramide (34.2%) and underuse of dexamethasone (66.5%) being the most frequently reported trends. Conclusion: This study shows a lack of conformity to antiemetic guidelines, resulting mainly in overtreatment. Although vomiting was well-managed, nausea remains under controlled and requires additional medical attention. The lack of knowledge and motivation are considered barriers to CPG implementation.

Effectiveness of a novel, fixed dose combination of netupitant and palonosetron in prevention of chemotherapy induced nausea and vomiting: A real-life study from India

BACKGROUND A new,oral fixed dose combination of highly selective neurokinin-1 receptor antagonist,netupitant with 5HT3 receptor antagonist,netupitant and palonosetron(NEPA)was approved in India for prevention of chemotherapy induced nausea and vomiting(CINV).AIM To assess effectiveness of NEPA in real-world scenario.METHODS We retrospectively assessed the medical records and patient dairies of adult patients who received highly emetogenic or moderately emetogenic chemotherapy(HEC/MEC)and treated with NEPA(Netupitant 300 mg+Palanosetron 0.50 mg)for prevention of CINV.Complete response(CR)was defined as no emesis or no requirement of rescue medication in overall phase(0 to 5 d),acute phase(0-24 h)and delayed phase(2 to 5 d).RESULTS In 403 patients included in the analysis,mean age was 56.24±11.11 years and 55.09%were females.Breast cancer(25.06%)was most common malignancy encountered.HEC and MEC were administered in 54.6%and 45.4%patients respectively.CR in overall phase was 93.79%whereas it was 98.01%in acute CINV and 93.79%in delayed CINV.Overall CR in HEC and MEC groups was 93.63%and 93.98%respectively.CR was more than 90%in different chemotherapy cycles except in group of patients of cycle 4 where CR was 88.88%.CONCLUSION NEPA is a novel combination that is effective in preventing CINV in up to 93%cases treated with highly emetogenic or moderately emetogenic chemotherapy.This study brings the first real-life evidence of its effectiveness in India population.

Controlling Chemotherapy-Induced Nausea and Vomiting with Neurokinin-1 Receptor Antagonists in Patients on AC-Based Chemotherapy—Are We There Yet?

Chemotherapy-induced nausea and vomiting (CINV) are distressing side effects of chemotherapy. Neurokinin-1 receptor antagonists (NK1-RAs) have been incorporated in the contemporary management of CINV. However, clinical studies on NK1-RAs have shown mixed results in reducing CINV risk. Most studies focused on the use of aprepitant (APR) and casopitant (CAS) in breast cancer patients receiving AC-type (doxorubicin and cyclophosphamide) chemotherapy. In this study, we compared the study design and clinical efficacies of these NK1-RAs in reducing CINV risk. Among the selected eight studies, 4 APR Randomized Controlled Trials (RCTs), 2 APR Observational Studies (OSs) and 2 CAS RCTs were identified. Patient-related characteristics such as the proportion of females (60.0% - 100.0%), age (46.5 - 59.5 years), histories of motion (5.6% - 47.0% in NK1-RA arms) and morning sicknesses (14.2% - 45.0% in NK1-RA arms) and types of antiemetic regimens;as well as chemotherapy-related characteristics such as the proportion of patients on AC chemotherapy (15.0% - 100.0%) varied greatly. In terms of efficacies, both APR and CAS improved overall CR and vomiting in majority of the studies. None of the studies, however, demonstrated that NK1-RA could provide adequate nausea control. To conclude, NK1-RAs are effective in improving vomiting and overall CR, but not useful in controlling nausea or attaining CC, the ideal CINV endpoint. A shift in paradigm is needed for future CINV research. As healthcare providers continue to strive for optimum CINV control in their patients, we hope this review can help them make better informed clinical decisions.

Auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients:Perspectives from the traditional zang-fu organs and meridians theory

This paper presents the theoretical background of using auricular therapy(AT)for managing chemotherapy-induced nausea and vomiting(CINV)from the perspectives of traditional zang-fu organs and meridian theory.The zang-fu organs of stomach,spleen and liver play a crucial role in regulating the gastrointestinal functions.The chemotherapeutic agents can significantly impede the gastrointestinal functions and subsequently contribute to various gastrointestinal symptoms including nausea and vomiting.Dysfunctions of the stomach,spleen and liver can correspond to specific auricular acupoints,while by stimulating those acupoints,the chaotic Qi movement can be reversed to its normal status,and the hyperactivities of the gastrointestinal system can also be alleviated to reduce the CINV symptoms.Clinical studies based on such theory have well supported the effects of AT on CINV.However,relationships between the traditional theory and the modern medicine understanding of the CINV mechanisms remain unknown and should be further explored in future research.

Summary of the Best Evidence for the Evaluation and Management of Chemotherapy-Related Nausea and Vomiting in Cancer Patients

Objective: To summarize the best evidence for the evaluation and management of chemotherapy-related nausea and vomiting in cancer patients, so as to promote the standardized management of chemotherapy-related nausea and vomiting in cancer patients. Methods: A computer search was conducted for all evidence on chemotherapy-associated nausea and vomiting interventions, including guidelines, expert consensus, best clinical practice information booklet, recommended practice, evidence summary, and systematic review. The search period is from April 30, 2022. After the literature quality evaluation, the evidence extraction and summary of the literature meeting the quality standards. Results: A total of 16 literatures were included, including 9 guidelines, 5 systematic reviews and 2 expert consensus papers. 46 pieces of best evidence on the assessment and management of chemotherapy related nausea and vomiting in cancer patients were summarized, including 6 aspects including risk assessment and management, non-drug management, drug management, multidisciplinary cooperation, education and training, and health education. Conclusion: This study summarized the current best evidence on the assessment and management of chemotherapy-related nausea and vomiting in cancer patients. Clinical staff should apply evidence according to specific clinical scenarios, professional skills and patients’ wishes in order to reduce the degree and incidence of chemotherapy-related nausea and vomiting in cancer patients and improve the quality of care.

MAGNETIC DISK APPLIED ON NEIGUAN POINT FOR PREVENTION AND TREATMENT OF CISPLATIN-INDUCED NAUSEA AND VOMITING

Cisplatin is commonly used in the treat-ment of cancers,but at the same time oftencauses side-effects like severe nausea andvomiting,which cannot be prevented ortreated satisfactorily with ordinary westernor traditional Chinese drugs,thus hinderingthe chemotherapy from being carried outsmoothly.We tried several methods to tack-le the situation,and found that placing a flatpiece of magnetic disk on Neiguan pointhad a remarkable effect.The following is areport of our work.

Role of progressive muscle relaxation in preventing and alleviating of nausea and vomiting caused by chemotherapy among cancer patients: A protocol of systematic review

Background and aim:Progressive muscle relaxation(PMR)is one of the most common complementary and alternative therapies.Published systematic review unfolded that PMR has a positive impact on chemotherapy-induced nausea and vomiting among adult cancer patients.However,the pooled findings were not reliable and valid because included trials have poor quality.It must be noted is that additional studies with good quality have been published recently.So,we design this updated systematic review to comprehensively establish the efficacy of PMR for the of chemotherapy-induced nausea and vomiting among cancer patients.Methods:We will search PubMed,Cochrane Controlled Register of Trial(CENTRAL),Cumulative Index to Nursing and Allied Health Literature(CINAHL),China Biomedical Literature database(CBM),China National Knowledge Infrastructure(CNKI),and Wanfang data to capture all potential items.Data extraction sheet will be used to extract all essential information,the Cochrane risk of bias assessment tool will be utilized to appraise the risk of bias of eligible studies.Finally,a quantitative analysis will be performed if sufficient data were obtained.In contrast,a qualitative analysis will be used to summarize the results of all included studies.Ethics and dissemination:Ethics approval and patient written informed consent will not be required because all of the analyses in the present study will be performed based on data from published studies.We will submit our systematic review and network meta-analysis to a peer reviewed scientific journal for publication.

针刺联合止吐药治疗胃癌化疗相关恶心呕吐的临床观察

[目的]本研究观察针刺治疗胃癌化疗相关性恶心呕吐(CINV)的疗效。[方法]收集2022年1月—2023年12月住院的胃癌患者。根据化疗期间是否行针刺治疗,所有患者分为常规治疗组和联合针刺组。观察指标为急性恶心和呕吐及延迟的恶心和呕吐的发生率、化疗期间恶心和呕吐总次数、生活质量、安全性和止吐药物相关不良反应。[结果]与常规治疗组相比,联合针刺组能够减少化疗后急性CINV和延迟CINV的发生(P<0.05),并且能够减少化疗期间恶心和呕吐发生总次数(P<0.05)。针刺能提高胃癌患者生活质量(P=0.028)。针刺治疗安全,并且针刺能够能减少止吐药物相关的便秘(P=0.031)和腹泻(P=0.005)等不良反应的发生。[结论]针刺联合止吐药可降低晚期胃癌CINV的发生,提高患者的生活质量,同时降低止吐药物相关不良反应的发生。

子午流注腕踝针疗法防治化疗所致恶心呕吐的效果研究

目的探讨子午流注腕踝针疗法防治化疗所致恶心呕吐的临床效果。方法选取接受静脉化疗的肿瘤患者212例住院患者随机分为观察组107例、对照组105例。对照组采用常规护理方法,观察组在对照组的基础上给予腕踝针干预治疗。观察化疗后所致恶心呕吐发生率、严重程度、焦虑抑郁、日常生活能力。结果观察组患者化疗后第6天恶心呕吐发生率、严重程度、焦虑抑郁低于对照组(P<0.01),观察组患者化疗后第6天日常生活能力高于对照组(P<0.01)。结论子午流注腕踝针疗法可有效降低化疗所致肿瘤患者恶心呕吐发生率及严重程度,缓解焦虑情绪,提高生存质量具有较好的临床效果。

信息化支持下多学科团队对淋巴瘤化疗所致恶心呕吐患者个性化管理的效果分析

目的探讨信息化支持下多学科团队对淋巴瘤化疗所致恶心呕吐(CINV)患者个性化管理的效果。方法选取2022年1月至2023年6月江西省肿瘤医院收治的70例CINV淋巴瘤患者作为研究对象,按照随机数字表法分为观察组(35例)和对照组(35例)。对照组采用常规护理,观察组采用信息化支持下多学科团队行个性化管理。比较两组患者的恶心呕吐干预效果、负性情绪、遵医行为及生命质量。结果观察组对恶心呕吐的干预总有效率高于对照组,差异有统计学意义(P<0.05);干预后,观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组,差异有统计学意义(P<0.05);观察组遵从率高于对照组,差异有统计学意义(P<0.05);干预后,观察组生命质量评分低于对照组,差异有统计学意义(P<0.05)。结论信息化支持下多学科团队对CINV淋巴瘤患者予以个性化管理,有助于降低CINV发生率,减轻负性情绪,提高遵医行为和生命质量,值得临床推广应用。

四联方案预防含顺铂方案多日化疗致恶心呕吐的效果和安全性研究

目的评价四联方案预防含顺铂方案多日化疗所致恶心呕吐(CINV)的有效性和安全性。方法选取以含顺铂药物进行化疗的112例恶性肿瘤患者。以随机数字表法将患者分为试验组与对照组,每组56例。对照组接受含有顺铂的化疗方案时给予三联方案(福沙匹坦双葡甲胺+盐酸昂丹司琼+地塞米松),试验组在对照组基础上给予含奥氮平的四联方案。观察2组恶心及呕吐发生情况、生活质量[呕吐生活功能量表(FILE)]及焦虑抑郁[医院焦虑抑郁量表(HADS)]的变化。结果开始化疗后1~9 d,试验组恶心、呕吐发生率低于对照组,试验组延迟期恶心、呕吐发生率低于对照组(P<0.05);开始化疗后9 d,试验组FILE的恶心、呕吐及总分高于对照组(P<0.05);2组开始化疗后1、9 d焦虑、抑郁评分及不良反应发生率比较差异无统计学意义(P>0.05)。结论四联止吐方案可提高对含顺铂多日化疗方案致CINV的控制率,尤其是针对延迟性恶心、呕吐的控制,改善患者化疗期间的生活质量,且安全性较好。

中药穴位贴敷联合音乐疗法对宫颈癌化疗所致恶心呕吐的干预效果分析

目的观察中药穴位贴敷联合音乐疗法对宫颈癌化疗所致恶心呕吐的干预效果。方法纳入宫颈癌化疗治疗所致恶心呕吐的患者76例,采用随机数字表法分为2组。对照组37例予音乐疗法,研究组39例予中药穴位贴敷联合音乐疗法干预。2组均21天为1个疗程,治疗4个疗程。比较2组治疗前后血小板计数、白细胞计数、血红蛋白水平、恶心及呕吐指数评估量表(INVR)和生活质量评分(QOL),记录2组恶心呕吐发生情况,统计对比2组疗效。结果研究组总有效率92.31%(36/39),对照组总有效率72.97%(27/37),研究组临床疗效优于对照组(P<0.05)。2组治疗后血小板计数、白细胞计数及血红蛋白水平均较本组治疗前降低(P<0.05),且研究组治疗后均低于对照组(P<0.05)。2组治疗前后INVR评分比较2组治疗后INVR各项评分均较本组治疗前降低(P<0.05),且研究组治疗后均低于对照组(P<0.05)。2组治疗后QOL各项评分均较本组治疗前升高(P<0.05),且研究组治疗后均高于对照组(P<0.05)。2组治疗当日恶心呕吐发生情况比较差异无统计学意义(P>0.05)。治疗结束后当日研究组恶心呕吐发生率均低于对照组(P<0.05)。结论经中药穴位贴敷联合音乐疗法对宫颈癌化疗所致恶心呕吐患者进行治疗,能显著改善患者恶心呕吐症状,提高患者生活质量,临床效果显著。

耳穴贴压配合穴位按摩改善胰腺癌化疗不良反应疗效观察

目的 探讨耳穴贴压配合穴位按摩改善胰腺癌化疗引起不良反应的临床疗效。方法 将93例胰腺癌化疗患者随机分为对照组、试验1组和试验2组,各31例。对照组行常规治疗,试验1组在常规治疗基础上加以耳穴贴压;试验2组则在常规治疗基础上予以耳穴贴压联合穴位按摩治疗,观察3组干预前后恶心呕吐、疲乏等躯体症状及自我效能状况。结果 在干预48 h后,3组恶心、呕吐得分较干预后12、24 h均降低(P均<0.001);对照组中文版罗德恶心及呕吐指数评分估量表得分高于试验1组和试验2组(P=0.009、<0.001),且试验1组得分高于试验2组(P=0.014)。在干预48 h后,3组Piper疲乏评估修订量表评分均低于干预后12、24 h(P均<0.001),试验1组、试验2组均低于对照组(P=0.038、0.012),而试验1组与试验2组比较差异无统计学意义(P=0.969)。在干预48 h后,对照组癌症自我效能感量表评分较干预后12、24 h降低(P均<0.001),试验1、试验2组评分较干预后12、24 h均升高(P均<0.001);试验1组、试验2组癌症自我效能感量表评分均高于对照组(P均<0.001),而试验2组略高于试验1组(P=0.132)。结论 相较于胰腺癌的常规治疗方法,耳穴贴压配合穴位按摩可有效降低化疗过程中的不良反应程度,降低恶心、呕吐和疲乏的发生率,缓解患者治疗压力,增强患者的自我效能感,促进患者更积极地面对胰腺癌治疗,具备临床推广应用价值。

坎离砂穴位贴敷预防乳腺癌化疗相关性恶心呕吐临床研究

目的:观察坎离砂穴位贴敷预防乳腺癌化疗相关性恶心呕吐(CINV)的疗效。方法:选取符合纳排标准的109例乳腺癌化疗患者为研究对象,按入院先后顺序分为试验组54例及对照组55例。对照组使用常规止吐治疗及饮食指导,试验组在对照组基础上加用坎离砂穴位贴敷治疗。观察2组化疗24 h至第7天恶心呕吐发生率及严重程度,比较2组急性呕吐、迟发性恶心呕吐治疗疗效。结果:化疗后24 h~7 d,试验组恶心发生率及严重程度均低于对照组,差异有统计学意义(P<0.05)。接受治疗后,试验组恶心发生率随着时间推移而降低,在第3天对照组恶心发生率达到高峰时,与试验组比较存在显著差异,化疗后第5~7天,2组变化趋势也有明显差异。整体治疗后各时间段试验组恶心发生率均低于治疗组。化疗后24 h~7 d,试验组呕吐发生率及严重程度均低于对照组,差异有统计学意义(P<0.05)。接受治疗后,对照组呕吐发生率随着时间推移稍有降低,仍具有较高峰值,试验组呕吐发生率趋于低走势,2组呕吐发生率变化趋势有明显差异。整体治疗后各时间段试验组呕吐发生率均低于治疗组。试验组对急性呕吐和迟发性呕吐疗效的有效率均达100%,对照组急性呕吐疗效有效率为87.3%,迟发性呕吐疗效的有效率为80.0%,试验组疗效均优于对照组,差异均有统计学意义(P<0.001)。结论:坎离砂穴位可预防乳腺癌CINV的发生,能有效缓解Ⅰ度以上程度的急性、迟发性恶心呕吐,操作简便、可行。

胃癌术后辅助化疗期间恶心呕吐风险预测模型的建立及验证

目的探讨胃癌病人手术后化疗期间恶心呕吐的风险因素,并构建相应的风险预测模型。方法2020年2月~2021年2月收治的胃癌病人作为建模集组,用于探讨胃癌病人手术后化疗期间恶心呕吐的风险因素,并构建相应的风险预测模型,将2021年3月~2022年2月(第1年)、2022年3月~2023年2月(第2年)、2023年3月~2024年2月(第3年)作为验证集组用于验证建模集组构建的风险预测模型。统计建模集组病人化疗期间呕吐发生情况。采用单因素和多因素Logistic回归分析胃癌病人手术后化疗期间恶心呕吐风险因素,并构建相应的风险预测模型。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)以2021年3月~2024年2月3年的验证集验证列线图预测模型的准确性。结果建模集组共纳入112例,其中75例未发生化疗相关性恶心呕吐,纳入对照组,37例病人发生了化疗相关性恶心呕吐,纳入观察组。单因素分析显示,年龄、性别、饮酒史、晕动病史、化疗次数、既往化疗相关性恶心呕吐史、妊吐史、匹茨堡睡眠质量指数(PSQI)、心理预期发生化疗后恶心呕吐等与病人发生化疗相关性恶心呕吐有关(P<0.05)。将单因素分析得到具有统计学意义的因素进行Logistic回归分析,结果显示,年龄、性别、晕动病史、化疗次数、妊吐史、PSQI、心理预期发生化疗后恶心呕吐是胃癌病人术后化疗期间恶心呕吐的危险因素(P<0.05)。根据Logistic回归得到具有统计学意义的因素构建风险预测模型。使用Bootstrap法对模型进行内部验证,第1年验证集组ROC曲线下面积(AUC)为0.71(95%CI:0.71~1.00),第2年验证集组0.69(95%CI:0.58~0.96),第3年验证集组0.66(95%CI:0.54~0.95)。结论年龄、性别、晕动病史、化疗次数、妊吐史、PSQI、心理预期发生化疗后恶心呕吐是胃癌病人术后化疗期间恶心呕吐的危险因素,上述因素构建的胃癌病人化疗期间恶心呕吐的风险预测模型具有较好的预测效能。

阿瑞匹坦与福沙匹坦预防高致吐化疗方案相关恶心呕吐的meta分析

目的系统评价阿瑞匹坦与福沙匹坦预防高致吐性化疗(HEC)相关恶心、呕吐的疗效及安全性。方法计算机检索Embase、PubMed、Cochrane Library、知网、万方、维普自建库至2022年12月有关福沙匹坦和阿瑞匹坦预防HEC相关恶心呕吐疗效与安全性的随机对照试验。2名研究者独立筛选并评价偏倚风险后,采用RevMan 5.4软件进行meta分析。结果最终纳入7篇文献,共4932例患者。meta分析结果显示,福沙匹坦与阿瑞匹坦总观察期及延迟期呕吐完全缓解率,总观察期、急性期、延迟期呕吐完全控制率,解救治疗比例,不良反应发生率方面差异均无统计学意义(P>0.05);福沙匹坦急性期呕吐完全缓解率高于阿瑞匹坦[RR=1.02,95%CI(1.00,1.04),P<0.05]。结论福沙匹坦和阿瑞匹坦预防HEC相关恶心呕吐效果相当,患者耐受性较好,福沙匹坦预防急性期呕吐优于阿瑞匹坦。

揿针疗法防治软组织肉瘤患儿化疗所致恶心呕吐的效果

目的观察揿针疗法防治软组织肉瘤(soft tissue sarcoma,STS)患儿化疗所致恶心呕吐(chemotherapyinduced nausea and vomting,CINV)的效果。方法选取2021年5月—2022年5月首都医科大学附属北京儿童医院肿瘤内科病房收治的STS患儿74例,按照随机数字表法将患儿分为试验组和对照组各37例。2组均接受长春新碱+阿霉素+环磷酰胺(vincristine+doxorubicin+cyclophosphamide,VDC)方案化疗,试验组在上述化疗基础上加揿针治疗。对比2组化疗第1、2天CINV发生情况和生活功能指数量表(functional living index-emesis,FLIE)评分。结果与对照组比较,试验组化疗第1、2天恶心、呕吐严重程度更低(P<0.05),化疗期间FLIE评分高(P<0.05)。结论揿针疗法可减少STS患儿化疗所致CINV的发生,提高患儿化疗期间的生活质量。

四药联合方案对肺癌化疗患者的止吐效果及消化道症状的影响

目的观察在肺癌化疗患者中应用阿瑞匹坦、地塞米松、昂丹司琼、奥氮平四药联合方案的止吐效果及其对消化道症状的影响。方法本研究纳入2020年1月—2022年10月黄山首康医院收治的144例肺癌化疗患者,所有患者均接受含顺铂方案化疗。将144例肺癌化疗患者以随机数字表格法分组,对照组72例予以地塞米松、昂丹司琼、奥氮平三联方案止吐,观察组72例患者在对照组基础上加用阿瑞匹坦行四联止吐治疗,对比两组患者的止吐治疗有效率,干预后不同阶段诱发性恶心、呕吐发生率,消化道症状控制情况。结果观察组治疗有效率为91.67%,显著高于对照组的75.00%(P<0.05)。观察组患者急性期、迟发期、持续期等不同阶段诱发性恶心、呕吐发生率均低于对照组(P<0.05)。消化道症状控制方面,观察组患者呕吐天数、补救性止吐人数均低于对照组(P<0.05),且止吐效果满意人数、KPS评分均高于对照组(P<0.05)。观察组与对照组治疗期间发生的非化疗药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿瑞匹坦、地塞米松、昂丹司琼、奥氮平四药联合方案对肺癌化疗患者诱导性恶心、呕吐等消化道症状有较好的预防和治疗效果,可提高患者对止吐效果的满意度,且安全性良好,不增加非化疗不良反应风险。

含奈妥匹坦帕洛诺司琼胶囊方案预防肺癌顺铂化疗相关恶心呕吐的临床疗效

目的:探究含奈妥匹坦帕洛诺司琼胶囊方案预防肺癌顺铂化疗相关恶心呕吐(CINV)的临床疗效。方法:回顾性收集2021年8月—2023年12月于泉州市中医院接受含顺铂方案化疗治疗的80例肺癌患者的临床资料,按照不同的治疗方案分为两组,对照组40例采取静脉用甲磺酸多拉司琼注射液联合地塞米松预防CINV,观察组40例采用口服奈妥匹坦帕洛诺司琼胶囊联合地塞米松预防CINV,比较两组患者化疗期间恶心呕吐严重程度(恶心呕吐缓解率)、药物不良反应及化疗后生活质量变化情况。结果:观察组恶心呕吐缓解率较对照组高(P<0.05)。两组治疗期间药物不良反应发生率比较,差异无统计学意义(P>0.05)。观察组化疗后恶心呕吐生活功能指数量表(FLIE)的两个分量表评分和总分均较对照组高,差异均有统计学意义(P<0.001)。结论:预防性使用含奈妥匹坦帕洛诺司琼胶囊止吐方案可有效改善含顺铂方案CINV的严重程度,提升患者生活质量。