Tsavaris N, Tsoutsos H, Bacoyannis C, Mylonakis N, Karvounis N, Kozatsani-Halividi D, Tsaroucha-Noutsou E, Klinaki A, Kosmidis P
Second Department of Medical Oncology, Metaxa Cancer Hospital, Piraeus, Greece.
Chemotherapy. 1991;37(5):364-70. doi: 10.1159/000238880.
In order to potentiate the efficacy of antiemetic drugs such as metoclopramide (MCP) and the new drug GR 38032F, adjuvant antiemetic drugs such as benzodiazepines are used in cancer patients receiving chemotherapy. The purpose of our prospective study was to investigate the efficacy of alprazolam (APZ), a newer diazepam, as an adjuvant antiemetic drug, when combined with MCP, in carboplatin (JM8)-based chemotherapy. Thus, 42 patients entered this study. First they received only MCP 1 mg/kg in 15 min infusion (arm A). In the next cycle they received the combination of MCP in the same dose and a tablet of APZ 0.25 mg, 30 min before JM8 infusion and then 3.5, 5.5 and 11.5 h after (arm B). JM8 was administered alone (400 mg/m2) or in combination (300 mg/m2) with vinblastine (6 mg/m2), etoposide (100 mg/m2) or 5-fluorouracil (1,000 mg/m2). In arm A, according to the WHO classification, nausea was intense (p less than 0.003) and the duration of nausea longer (p less than 0.002). In arm B more patients did not present vomiting (p less than 0.018). Secondary effects such as appetite (p less than 0.04), diarrhea (p less than 0.064), diaphoresis (p less than 0.085) and headache (p less than 0.024) were worst in arm A. We conclude that APZ increases the antiemetic effect of MCP on JM8. APZ is a useful adjuvant antiemetic drug, especially against the development of anticipatory anxiety, nausea and vomiting that many cancer patients presented during chemotherapy.
为增强胃复安（MCP）等止吐药物以及新药GR 38032F的疗效，苯二氮䓬类等辅助止吐药物被用于接受化疗的癌症患者。我们前瞻性研究的目的是调查新型地西泮类药物阿普唑仑（APZ）与MCP联合用于基于卡铂（JM8）的化疗时作为辅助止吐药物的疗效。因此，42名患者进入本研究。首先，他们仅在15分钟内输注1mg/kg的MCP（A组）。在下一周期，他们在输注JM8前30分钟接受相同剂量的MCP与一片0.25mg阿普唑仑的联合用药，然后在输注后3.5、5.5和11.5小时再次用药（B组）。JM8单独给药（400mg/m²）或与长春碱（6mg/m²）、依托泊苷（100mg/m²）或5-氟尿嘧啶（1000mg/m²）联合给药。在A组，根据世界卫生组织的分类，恶心程度强烈（p<0.003）且恶心持续时间更长（p<0.002）。在B组，更多患者未出现呕吐（p<0.018）。诸如食欲（p<0.04）、腹泻（p<0.064）、发汗（p<0.085）和头痛（p<0.024）等副作用在A组更严重。我们得出结论，阿普唑仑可增强MCP对JM8的止吐作用。阿普唑仑是一种有用的辅助止吐药物，尤其可对抗许多癌症患者在化疗期间出现的预期性焦虑、恶心和呕吐。
