Treish Imad, Shord Stacy, Valgus John, Harvey Donald, Nagy Jessica, Stegal Jennifer, Lindley Celeste
University of North Carolina Hospitals, Manning Drive, Chapel Hill, NC 27514, USA.
Support Care Cancer. 2003 Aug;11(8):516-21. doi: 10.1007/s00520-003-0467-3. Epub 2003 Jun 27.
Our goal was to evaluate the efficacy and tolerability of the Reliefband as an adjunct to standard antiemetics in patients receiving moderately-high to highly emetogenic chemotherapy.
Forty-nine adult cancer patients receiving moderately-high or highly emetogenic chemotherapy were randomized to receive either the active Reliefband ( n=26) or an inactive device ( n=23). Patients continued to receive all scheduled and as needed antiemetic agents as prescribed. The device was worn the day of chemotherapy administration for 5 days (days 1-5). Patients maintained a daily dairy of nausea severity, vomiting and retching episodes, and antiemetic medications taken. Each patient completed a Functional Living Index Emesis (FLIE) and a tolerability survey at the conclusion of the study. A Wilcoxon rank sum test was used to compare the number of vomiting episodes, severity of nausea and FLIE scores between the two groups.
Patients wearing the active Relifband experienced less vomiting (Reliefband 1.9 versus inactive device 4.6 mean episodes; p=0.05), retching (1.4 versus 3.6 mean episodes; p=0.05), and nausea severity (0.91 versus 1.65 mean cm/day; p=0.01) over the 5-day period compared to patients wearing the inactive device. Vomiting was statistically significantly reduced during the delayed period (0.42 versus 1; p=0.032), whereas nausea was significantly reduced during the acute (0.71 versus 2.3; p=0.028) and delayed (1.8 versus 3.3; p=0.020) periods. FLIE scores did not differ between the two treatment groups (91 versus 80; p=0.088).
This study suggests that patients receiving moderately-high to highly emetogenic chemotherapy who experience nausea and vomiting despite scheduled antiemetics may benefit from the use of the Reliefband as an adjunct to antiemetics. Limitations of this study include differences in risk factors for emesis, chemotherapy, and antiemetic regimens. A larger, better, controlled randomized study is needed to better define optimal use of this device.
我们的目标是评估在接受中高度至高度致吐性化疗的患者中,Reliefband作为标准止吐药辅助手段的疗效和耐受性。
49名接受中高度或高度致吐性化疗的成年癌症患者被随机分为两组,分别接受活性Reliefband(n = 26)或无活性装置(n = 23)。患者继续按规定接受所有预定的和必要时的止吐药物。该装置在化疗给药当天佩戴5天(第1 - 5天)。患者记录每日恶心严重程度、呕吐和干呕发作情况以及服用的止吐药物。在研究结束时,每位患者完成一份功能性生活指数呕吐量表(FLIE)和一份耐受性调查。采用Wilcoxon秩和检验比较两组之间的呕吐发作次数、恶心严重程度和FLIE评分。
与佩戴无活性装置的患者相比,佩戴活性Reliefband的患者在5天期间呕吐次数更少(Reliefband组平均发作1.9次,无活性装置组平均发作4.6次;p = 0.05)、干呕次数更少(分别为1.4次和3.6次;p = 0.05)、恶心严重程度更低(分别为0.91和1.65厘米/天;p = 0.01)。在延迟期呕吐次数有统计学显著减少(分别为0.42次和1次;p = 0.032);而在急性期(分别为0.71次和2.3次;p = 0.028)和延迟期(分别为1.8次和3.3次;p = 0.020)恶心程度显著降低。两组的FLIE评分无差异(分别为91和80;p = 0.088)。
本研究表明,在接受中高度至高度致吐性化疗且尽管使用了预定的止吐药仍出现恶心和呕吐的患者中,使用Reliefband作为止吐药的辅助手段可能有益。本研究的局限性包括呕吐风险因素、化疗和止吐方案存在差异。需要进行一项更大规模、更好控制的随机研究,以更好地确定该装置的最佳用途。