Vardy J, Chiew K S, Galica J, Pond G R, Tannock I F
Department of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, 610 University Ave, Toronto, Ontario, Canada M5G2M9.
Br J Cancer. 2006 Apr 10;94(7):1011-5. doi: 10.1038/sj.bjc.6603048.
The role of dexamethasone to reduce delayed emesis following highly emetogenic chemotherapy is proven, but there is less evidence of benefit after mild-moderately emetogenic regimens. Here, we develop and evaluate a Dexamethasone Symptom Questionnaire (DSQ) to assess the side effects of dexamethasone in the week after patients receive moderately emetogenic chemotherapy. The DSQ was first optimised with the aid of a focus group. Sixty patients receiving oral dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy for cancer completed and then evaluated the DSQ. Patients reported that the DSQ was clearly worded and addressed items important to them. Patients receiving dexamethasone reported moderate-severe problems with insomnia (45%), indigestion/epigastric discomfort (27%), agitation (27%), increased appetite (19%), weight gain (16%) and acne (15%) in the week following chemotherapy. The side effects of dexamethasone may outweigh its benefits when used with moderately emetogenic chemotherapy. A randomised, double-blind crossover trial is underway to determine the effect of dexamethasone on nausea and vomiting, and the impact of side effects of dexamethasone and of nausea and vomiting on quality of life.
地塞米松在减轻高度致吐性化疗后延迟性呕吐方面的作用已得到证实，但在轻度至中度致吐性化疗方案后获益的证据较少。在此，我们开发并评估了一种地塞米松症状问卷（DSQ），以评估患者接受中度致吐性化疗后一周内地塞米松的副作用。DSQ首先在一个焦点小组的帮助下进行了优化。60例因癌症接受中度致吐性化疗后口服地塞米松预防延迟性呕吐的患者完成并评估了DSQ。患者报告称，DSQ措辞清晰，涵盖了对他们重要的项目。接受地塞米松治疗的患者报告，化疗后一周内出现中度至重度失眠（45%）、消化不良/上腹部不适（27%）、烦躁不安（27%）、食欲增加（19%）、体重增加（16%）和痤疮（15%）等问题。与中度致吐性化疗联合使用时，地塞米松的副作用可能超过其益处。一项随机、双盲交叉试验正在进行中，以确定地塞米松对恶心和呕吐的影响，以及地塞米松副作用和恶心呕吐对生活质量的影响。
