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[止吐药及其临床评价]

[Antiemetics and its clinical evaluations].

作者信息

Furue H

机构信息

Dept. of Internal Medicine, Mizonokuchi Hospital, Teikyo University, School of Medicine, Japan.

出版信息

Gan To Kagaku Ryoho. 1992 Mar;19(3):294-301.

PMID:1543357
Abstract

Nausea and vomiting induced by anticancer agents are common problems associated with chemotherapy for cancer. Recent trials have examined a variety of antiemetics, representing several different classes of drugs. High dose metoclopramide provided the impetus for many of the current studies because of its effect against cisplatin induced vomiting. However, current regimens are not yet entirely effective in many patients receiving cisplatin or other highly emetogenic anticancer agents. A promising new class of antiemetics, 5-hydroxytryptamine receptor antagonists are undergoing clinical evaluations. Members of this class are easily and safely administered to patients receiving cisplatin or other emetogenic anticancer agents. These are highly active antiemetics, both prophylactic and interventional treatment. Lack of extrapyramidal reaction and other adverse effects associated with its use makes the drug a very attractive one. However, studies of antiemetics require consideration of methodologic issues that may not be of concern in trials of anticancer agents. The results of these studies can be affected by the patient population, the sample size, pharmacologic variables, the trial design, the method of analysis, etc. Recently, developments both in new-antiemetics and better ways of using the existing ones, lead us to cautious thought that nausea and vomiting due to cancer chemotherapy can be controlled substantially with benefit to the patients.

摘要

抗癌药物引起的恶心和呕吐是癌症化疗常见的相关问题。近期试验研究了多种止吐药,它们分属于不同的药物类别。高剂量甲氧氯普胺因其对顺铂所致呕吐的疗效,推动了当前许多研究。然而,对于许多接受顺铂或其他高致吐性抗癌药物治疗的患者,目前的治疗方案仍不完全有效。一类有前景的新型止吐药——5-羟色胺受体拮抗剂正在进行临床评估。这类药物的成员易于且安全地应用于接受顺铂或其他致吐性抗癌药物治疗的患者。它们是高效的止吐药,无论是预防性还是干预性治疗。缺乏锥体外系反应及与其使用相关的其他不良反应,使得该药物极具吸引力。然而,止吐药的研究需要考虑一些在抗癌药物试验中可能无需关注的方法学问题。这些研究的结果可能会受到患者群体、样本量、药理学变量、试验设计、分析方法等因素的影响。最近,新型止吐药的研发以及更好地使用现有药物的方法,使我们谨慎地认为,癌症化疗引起的恶心和呕吐能够得到有效控制,从而使患者受益。

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