Abali Hüseyin, Celik Ismail
S.B. Ankara Numune Hastanesi Medikal Onkoloji Kliniği, Ankara, Türkiye.
Cancer Invest. 2007 Apr-May;25(3):135-9. doi: 10.1080/07357900701208709.
Tropisetron, ondansetron, and granisetron are considered equally efficacious, supported by several international studies. However, there are interindividual variations in their metabolism that could affect efficacy. The clustering of such variations may change from one to another nation. Therefore, their equality must be validated in Turkish patients. The aim of this study was to compare their efficacies, side-effect profiles, and costs in the prophylaxis of emesis induced by moderate to high emetogenic chemotherapies.
A total of 158 patients with a median age of 48 years, 115 (72.8 percent) female and 43 (27.2 percent) male, were included, respectively. Fifty-one, 61, and 46 patients were allocated to tropisetron (5 mg), ondansetron (8 mg), and granisetron (3 mg IV) in combination with 8 mg dexamethasone, which were continued 5 mg once a day, 8 mg b.i.d. and 1 mg b.i.d. PO for 5 days, respectively.
The complete response (CR) rates in the control of acute emesis were 80.4 percent with tropisetron, 72.1 percent with ondansetron, and 71.7 percent granisetron (p = 0.877). CR rates in delayed emesis (Days 2-5) were 68.6 percent, 68.9 percent, and 76.1 percent, respectively (p = 0.527). Rates of freedom from nausea in the same period were 37.3 percent, 35.9 percent, and 33.9 percent (p = 0.949). Nausea control rates, side-effect profile did not differ. However, headache seemed to be encountered higher (45.6 percent) in Turkish patients than others (3.9-9 percent). Tropisetron is the least expensive one ($95.3 per cycle) according to current prices in Turkey.
There were no differences among the 3 serotonin antagonists with respect to efficacy and frequency of side-effects in our patients. Tropisetron is the least expensive at current prices. The choice may be based on other parameters, such as ease of administration and patient preference.
多项国际研究表明，托烷司琼、昂丹司琼和格拉司琼的疗效相当。然而，它们在代谢方面存在个体差异，这可能会影响疗效。这种差异的聚类情况在不同国家可能有所不同。因此，有必要在土耳其患者中验证它们的等效性。本研究旨在比较它们在预防中高度致吐性化疗引起的呕吐方面的疗效、副作用谱和成本。
共纳入年龄中位数为48岁的158例患者，其中女性115例（72.8%），男性43例（27.2%）。51例、61例和46例患者分别被分配接受托烷司琼（5mg）、昂丹司琼（8mg）和格拉司琼（3mg静脉注射）联合8mg地塞米松治疗，分别持续每日一次5mg、每日两次8mg和每日两次口服1mg，共5天。
在控制急性呕吐方面，托烷司琼的完全缓解（CR）率为80.4%，昂丹司琼为72.1%，格拉司琼为71.7%（p = 0.877）。延迟性呕吐（第2 - 5天）的CR率分别为68.6%、68.9%和76.1%（p = 0.527）。同期无恶心发生率分别为37.3%、35.9%和33.9%（p = 0.949）。恶心控制率、副作用谱无差异。然而，土耳其患者中头痛的发生率似乎较高（45.6%），高于其他患者（3.9% - 9%）。根据土耳其目前的价格，托烷司琼是最便宜的一种（每周期95.3美元）。
在我们的患者中，这三种5 - 羟色胺拮抗剂在疗效和副作用发生频率方面没有差异。按照目前的价格，托烷司琼最便宜。选择可能基于其他参数，如给药便利性和患者偏好。
