【摘要】 【关键词】 呕吐; 抗肿瘤联合化疗方案; 止吐药; 治疗结果 呕吐是肿瘤患者化疗时最常见的不良反应之一,化疗所致的严重恶心、呕吐等胃肠道反应使患者产生难以忍受的痛苦,影响正常治疗。因此,有效控制化疗患者的恶心、呕吐,对保证化疗计划的顺利实施具有重要意义。2009年3月~2010年2月,分别采用盐酸帕洛诺司琼、格拉司琼、昂丹司琼控制60例肿瘤患者化疗所致的恶心、呕吐,尤其是延迟期的反应,取得较好的疗效,报告如下。 1 资料与方法 1.1 一般资料 60例住院化疗的恶性肿瘤病人,经病理学或细胞学确诊,均无化疗禁忌症,排除消化道梗阻,无颅内压增高等可能引起呕吐的病症,化疗前24 h无呕吐,且未用过止吐药者。凡使用DDP 30 mg/(m2·d),第1~3 d联合化疗方案。男44例,女16例,年龄22~73岁,平均56岁。病种:鼻咽癌30例,食管癌16例,肺癌10例,宫颈癌4例。化疗前检查血、尿常规,肝肾功能,心电图等均正常。止吐药为盐酸帕洛诺司琼注射液(江苏正大天晴药业股份有限公司)0.25 mg/支、盐酸格拉司琼注射液3 mg/支,盐酸昂丹司琼注射液4 mg/支。 1.2 治疗 化疗方案: (1)DDP 30 mg/m2(第1~3天静脉推注),5FU每天750 mg/m2(第1~3天静脉滴注)。(2) 紫杉醇135 mg/m2(第1天静脉滴注),DDP用法与(1)同。止吐方案: 盐酸帕洛诺司琼注射液0.25 mg于第一天化疗前15 min静脉推注;盐酸格拉司琼注射液3 mg静脉滴注,每日2次,分别于化疗前、后15 min给药,连续用3 d;昂丹司琼8 mg静脉注射,于化疗前、后15 min给药,连续用3 d。 1.3 呕吐及止吐疗效 呕吐评价:呕吐1次/24 h为1级;呕吐2~5次/24 h,需要静脉补液<24 h为2级;呕吐≥6次/24 h,静脉补液或完全肠道外营养≥24 h为3级,有危及生命的并发症为4级,死亡为5级。止吐评价标准:24 h内无呕吐为完全缓解(CR),24 h内呕吐1~2次为部分缓解(PR),24 h内呕吐3~5次为轻度缓解(MR),24 h内呕吐多于5次为无效(NC)。有效控制率为CR+PR,完全缓解率即CR率,部分缓解率即PR率。 2 结果 3 讨论 【参考文献】 [2] Macciocchi A,Gallagher S.A phase II doseranging study to assess single intravenous doses of palonosetron for the prevention of highly emetogenic chemotherapyinduced nausea and vomiting[J].Proc Am Soc Clin Oncol ,2002(21):471a (Abstr 1480). [3] Gmlh R,Lichinitser M,Vegt SV,et al.Palonosetron improves prevention o f chemotherapy induced nausea and vomiting following moderately emetoge nic chemotherapy:results of a doubleblind randomized phaseⅢ trial comparing single doses of palonosetron with ondansetron [J].Ann of Oncol,2003(10):1570-l577. [4] Johnston D,Latreille J,Laberge F ,et al.Preventing nausea and vomiting during days 27 following high dose cisplatin chemotherapy (HDCP).A study by the National Can cer Institute of Canada Clinical Trials Group (NCICCTG)[J].Proc Am Soc Clin Oncol, 1995(14):529 (Abstr 1745). [5] Kaizer L,Warr D,Hoskins P,et al.Effet of schedule and maintenance on the antiemetic efficacy of ondansetron combined with dexamethasone in acute and delayed nausea and emesis in patients receiving moderately emetogenic chemotherapy:a phase III trial by the National Cancer Institute of Canada Clinical Trials Group[J].J Clin Oncol 1994(12):1050-1057. [6] Aapro MS,Thuerlimann B,Sessa C,et al.A randomized,doubleblind trial to compare the clinical efficacy of granisetron with metoclopramide,both combined with dexamethasone in the prophylaxis of chemotherapyinduced delayed emesis[J].Ann Oncol ,2003(14):291-297. [7] Eisenberg P,Figueroa Vadillo J,Zamora R,et a1.Improved prevention of moderately emetogenic chemotherapyinduced nausea and vomiting with palonose tron,a pharmacologically novel 5 HT 3 receptor antagonist:results of a phase III,singledose trial versus dolasetren[J].Cancer,2003(11):2473-2482. |
盐酸帕洛诺司琼、格拉司琼、昂丹司琼预防化疗呕吐的比较简介:
【摘要】 目的: 观察三种止吐药预防化疗引起呕吐的临床疗效和不良反应。方法: 采用DDP化疗方案治疗的肿瘤患者60例随机分为3组,分别给予国产帕洛诺司琼、格拉司琼、昂丹司琼,观察3种药物预防呕吐的 ... 责任编辑:admin |
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