Yeh Yu-Chen, McDonnell Anne, Klinger Elissa, Fowler Bridget, Matta Lina, Voit Daniel, Reddy Prabashni
Center for Drug Policy, Partners Healthcare, Needham, MA 02494, USA.
J Oncol Pharm Pract. 2011 Sep;17(3):179-85. doi: 10.1177/1078155210366491. Epub 2010 May 7.
To analyze the differences between ondansetron and palonosetron in healthcare resource use (i.e., inpatient/ outpatient encounters) among patients receiving intraperitoneal cisplatin.
A medical record review was performed. Intraperitoneal cisplatin administrations for gynecological cancers from January through June 2006 and from October 2007 through June 2008 were divided into two groups based on the serotonin-receptor antagonist used. The occurrence of chemotherapy-induced nausea and vomiting (CINV)-related hospital readmissions, emergency department visits, and outpatient encounters occurring within 7 days after cisplatin administration was compared. CINV-related resource use was defined as events associated with dehydration, hypovolemia, nausea/vomiting, hypokalemia, constipation, shortness of breath, or syncope/collapse.
Ondansetron or palonosetron was used in 39 and 89 cisplatin administrations, respectively. The baseline characteristics were similar between the groups with mean age of 59 years and ovarian cancer being the most common cancer. Length of stay was approximately 2 days. Palonosetron was always administered as a single-day therapy while one- or multi-day ondansetron therapy was administered in 27% and 73% of cycles, respectively. A trend towards more CINV-related hospitalizations with ondansetron versus palonosetron was observed (5.1% vs. 0%, p = 0.09) with no significant difference in other CINV-related encounters.
Palonosetron was associated with a trend to a lower risk of CINV-related hospital readmission than ondansetron in patients receiving intraperitoneal cisplatin for gynecological cancers, although not statistically significant. The duration of ondansetron therapy might be suboptimal with 27% of patients receiving only 1 day of therapy during hospital stay. These findings need to be confirmed in future studies.
分析接受腹腔内顺铂治疗的患者在医疗资源使用（即住院/门诊就诊）方面，昂丹司琼与帕洛诺司琼之间的差异。
进行了一项病历回顾。将2006年1月至6月以及2007年10月至2008年6月期间用于妇科癌症的腹腔内顺铂给药，根据所使用的5-羟色胺受体拮抗剂分为两组。比较顺铂给药后7天内化疗引起的恶心和呕吐（CINV）相关的再次住院、急诊就诊和门诊就诊情况。CINV相关的资源使用定义为与脱水、血容量不足、恶心/呕吐、低钾血症、便秘、呼吸急促或晕厥/虚脱相关的事件。
分别有39次和89次顺铂给药使用了昂丹司琼或帕洛诺司琼。两组的基线特征相似，平均年龄为59岁，卵巢癌是最常见的癌症。住院时间约为2天。帕洛诺司琼总是作为单日疗法给药，而昂丹司琼的单日或多日疗法分别在27%和73%的疗程中使用。观察到与帕洛诺司琼相比，昂丹司琼导致更多CINV相关住院的趋势（5.1%对0%，p = 0.09），在其他CINV相关就诊方面无显著差异。
在接受腹腔内顺铂治疗妇科癌症的患者中，帕洛诺司琼与CINV相关再次住院风险低于昂丹司琼的趋势相关，尽管无统计学意义。昂丹司琼治疗的持续时间可能不理想，27%的患者在住院期间仅接受1天治疗。这些发现需要在未来的研究中得到证实。
