Tonato M
Divisione Oncologia Medica, Ospedale Policlinico, Perugia, Italy.
Eur J Cancer. 1991;27 Suppl 1:S12-4; discussion S22.
Ondansetron as a single agent has been shown to be superior to metoclopramide in the control of acute nausea and vomiting induced by high-dose cisplatin, complete or major control (0-2 emetic episodes) being achieved in 65-75% of patients. In an attempt to further improve efficacy in this group of patients, a randomised, double-blind, crossover study was carried out comparing ondansetron with ondansetron plus dexamethasone. Ondansetron was given as three intravenous doses (0.15 mg/kg) 2-hourly and dexamethasone as a single intravenous dose of 20 mg prior to cisplatin (median 70 mg/m2, range 50-120 mg/m2). Complete control of emesis was achieved in 91% of patients receiving the combination of ondansetron plus dexamethasone and in 64% of patients receiving ondansetron alone (P less than 0.001). Nausea was absent in 89% of patients receiving the combination and in 66% of patients receiving ondansetron alone (P less than 0.0025). Both treatments were well tolerated. The addition of a single dose of dexamethasone to ondansetron significantly improves the control of emesis and nausea compared to ondansetron monotherapy in patients receiving high-dose cisplatin.
已证明，作为单一药物，昂丹司琼在控制大剂量顺铂引起的急性恶心和呕吐方面优于甲氧氯普胺，65%-75%的患者可实现完全或主要控制（呕吐发作0-2次）。为了进一步提高该组患者的疗效，开展了一项随机、双盲、交叉研究，比较昂丹司琼与昂丹司琼加地塞米松的效果。昂丹司琼每2小时静脉注射3次（0.15mg/kg），地塞米松在顺铂（中位剂量70mg/m²，范围50-120mg/m²）给药前静脉注射单次剂量20mg。接受昂丹司琼加地塞米松联合治疗的患者中，91%实现了呕吐的完全控制，而单独接受昂丹司琼治疗的患者中这一比例为64%（P<0.001）。接受联合治疗的患者中，89%无恶心症状，单独接受昂丹司琼治疗的患者中这一比例为66%（P<0.0025）。两种治疗的耐受性均良好。与昂丹司琼单药治疗相比，在接受大剂量顺铂治疗的患者中，昂丹司琼加单剂量地塞米松可显著改善呕吐和恶心的控制情况。
