摘要
背景与目的:造血干细胞移植患者因接受高剂量化放疗预处理而容易发生恶心呕吐,单用5-HT3受体拮抗剂治疗效果欠佳,而5-HT3受体拮抗剂使用的剂量、频率以及是否需联合其他止吐剂,尚无明确定论。本研究旨在对比观察托烷司琼(欧必亭)联合地塞米松、苯海拉明与单药托烷司琼对自体外周血干细胞移植(autologousperipheralbloodstemceltransplantation,APBSCT)患者接受高剂量化放疗所致恶心呕吐的作用和不良反应。方法:1998年12月～2002年9月,68例接受APBSCT的患者非随机分为A、B两组,分别用托烷司琼联合地塞米松、苯海拉明(A组)和单药托烷司琼(B组)治疗,对高剂量化放疗所致恶心呕吐进行治疗。治疗方案:A组40例,采用托烷司琼5mg静注,每日2次;地塞米松5～10mg静注,每日1次;苯海拉明20mg肌注,每日1次。B组28例,采用托烷司琼5mg静注,每日2次。结果:A、B两组急性恶心的完全缓解率(CR率)分别为55.0%和46.4%,总有效率分别为97.5%和85.7%,两组对比差异无显著性(P>0.05)。急性呕吐的CR率分别为77.5%和78.6%,总有效率分别为90.0%和92.9%,两组对比差异无显著性(P>0.05)。A组延迟性恶心、呕吐(第2～6天)的CR率和有效率较B组明显高,差异有显著性(P<0.05)。两组最常见的不良反应是腹部不适、便秘、头痛和头重感,不良反应均轻?
BACKGROUND & OBJECTIVE: High- dose conditioning regimens of ch emo- radiotherapy with or without total body irradiation (TBI) frequently induc es nausea and vomiting in patients who are supported with stem cell transplantat ion. 5- Hydroxytrypamine3 (5- HT3) receptor antagonists, when used alone, are unsatisfactory in the attenuation of emesis; Furthermore, consensus about their optimal dose, optimal dosing frequency and the combined use with other anti- em etic drugs are still controversial. The main objective of this trial was to obse rve the anti- emetic effectiveness and side effects of tropisetron plus dexamet hasone and diphenhydramine (Group A) and tropisetron alone (Group B) on the pati ents undergoing high- dose treatment for peripheral blood stem cell (PBSC) mobi lization and transplantation. METHODS: From December 1998 to September 2002, 68 patients undergoing autologous peripheral blood stem cell transplantation were a llotted into this study. All the eligible patients were divided into group A or B non- randomly to compare the efficacy of the two regimens in the prevention o f nausea and vomiting induced by high- dose treatment. Regimens:40 patients in group A were given tropisetron 5 mg,iv,every 12 h plus dexamethasone 5- 10 mg, iv, daily, and diphenhydramine, 20 mg, im, daily. Twenty- eight patients in gro up B were received tropisetron alone,5 mg,iv,every 12h. RESULTS: For nausea duri ng the acute phase, complete response rates of group A and B were 55% and 46.4 % , with an overall response rates of 97.5% and 85.7% ,of which the differen ce was insignificant (P >0.05). For vomiting during the acute phase, complete re sponse rates of group A and B were 77.5% and 78.6% , with an overall response rates of 90% and 92.9% , of which the difference was insignificant (P >0.05) . For delayed phase, both the complete response and overall response rates were higher in group A, with the difference significant (P< 0.05). The side effects o f both regimens were mild. Common side effects including
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2004年第4期456-460,共5页
Chinese Journal of Cancer
基金
国家"九五"攻关课题(No.96-906-01-12)~~
关键词
托烷司琼
预防措施
自体干细胞移植
高剂量
化疗
放疗
恶心呕吐
不良反应
Neoplasms
High- dose Chemo- radiotherapy
Autologous peripheral blood stem cell Transplantation
Tropisetron
Side effects
