Bremer K
Abt f. Hämatologie und Onkologie, Augusta-Kranken-Anstalt, Bochum, Germany.
Eur J Cancer. 1992;28A(6-7):1018-22. doi: 10.1016/0959-8049(92)90446-9.
200 cancer patients who were due to receive fractionated chemotherapy (cisplatin greater than or equal to 15, ifosfamide greater than or equal to 1.2 or etoposide greater than or equal to 120, all mg/m2 per day) for 5 days, entered a multicentre study. Patients were randomised single-blind to receive either prophylactic intravenous granisetron (40 micrograms/kg) or alizapride (4 mg/kg followed by 4 mg/kg at 4 and 8 h post-treatment) plus dexamethasone 8 mg. Granistron was superior to the combination in preventing nausea and vomiting (54% vs. 43% complete responders). The differences were in the cisplatin-treated group. The time to first episode of moderate to severe nausea was significantly longer in the granisetron group (P = 0.03). Dosing with granisetron was more simple, with over 85% of patients requiring only a single prophylactic dose. Fewer patients receiving granisetron experienced adverse events (48% vs. 62%, P = 0.047). The frequency of constipation was, as expected, significantly higher in the granisetron group. Extrapyramidal effects, which were not noted by any granisetron patient, occurred in 5.3% of comparator patients.
200名即将接受为期5天的分次化疗(顺铂每日≥15mg/m²、异环磷酰胺每日≥1.2g/m²或依托泊苷每日≥120mg/m²)的癌症患者进入了一项多中心研究。患者被随机单盲分组,分别接受预防性静脉注射格拉司琼(40μg/kg)或阿立必利(4mg/kg,治疗后4小时和8小时再各注射4mg/kg)加8mg地塞米松。在预防恶心和呕吐方面,格拉司琼优于联合用药组(完全缓解率分别为54%和43%)。差异存在于顺铂治疗组。格拉司琼组中至重度恶心首次发作的时间显著更长(P = 0.03)。格拉司琼的给药方式更简单,超过85%的患者仅需单次预防性给药。接受格拉司琼治疗的患者发生不良事件的比例更低(48%对62%,P = 0.047)。正如预期的那样,格拉司琼组便秘的发生率显著更高。格拉司琼组患者均未出现锥体外系反应,而对照药组患者的发生率为5.3%。