Choi Mi Rim, Jiles Cynthia, Seibel Nita L
Division of Hematology and Oncology, Children's National Medical Center, Washington, DC, USA.
J Pediatr Hematol Oncol. 2010 Oct;32(7):e268-71. doi: 10.1097/MPH.0b013e3181e5e1af.
One of the most common and distressing side effects for cancer patients is chemotherapy-induced nausea and vomiting (CINV). New antiemetics, such as the NK-1 receptor inhibitor aprepitant, have been reported to improve control of this side effect in adults. However, little is known about its effect in the pediatric oncology population, with only a few reported cases in the literature.
This was a retrospective chart review on the use of aprepitant in the pediatric oncology population in our institution.
Thirty-two charts and a total of 146 cycles of chemotherapy were reviewed. Mean age was 10 years. Highly emetogenic chemotherapy was used in 23/32 patients and moderately emetogenic chemotherapy in 9/32. Antiemetic regimens consisted of aprepitant+5-HT3 RA+dexamethasone (Regimen 1, 20/32 patients) or aprepitant +5-HT3 RA (Regimen 2, in 12/32). Eight out of thirty-two patients were chemotherapy-naïve and received aprepitant on their first cycle. In 24/32 patients, aprepitant was added later in their treatment, with 12/24 reporting resolution of CINV after its addition.
Aprepitant when combined with standard antiemetics, was well tolerated in the pediatric oncology population studied. However, there is still a need to conduct prospective studies to determine the optimal efficacy of aprepitant in the pediatric oncology population.
化疗引起的恶心和呕吐（CINV）是癌症患者最常见且令人痛苦的副作用之一。据报道，新型止吐药如NK-1受体抑制剂阿瑞匹坦可改善成人这一副作用的控制情况。然而，其在儿科肿瘤患者中的作用鲜为人知，文献中仅有少数病例报道。
这是一项对我院儿科肿瘤患者使用阿瑞匹坦情况的回顾性病历审查。
共审查了32份病历和146个化疗周期。平均年龄为10岁。32例患者中，23例使用了高致吐性化疗，9例使用了中度致吐性化疗。止吐方案包括阿瑞匹坦+5-羟色胺3受体拮抗剂（5-HT3 RA）+地塞米松（方案1，20/32例患者）或阿瑞匹坦+5-HT3 RA（方案2，12/32例）。32例患者中有8例为初治化疗患者，在其首个周期接受了阿瑞匹坦治疗。24/32例患者在治疗后期加用了阿瑞匹坦，其中12/24例患者在加用后CINV症状缓解。
在本研究的儿科肿瘤患者中，阿瑞匹坦与标准止吐药联合使用时耐受性良好。然而，仍需进行前瞻性研究以确定阿瑞匹坦在儿科肿瘤患者中的最佳疗效。
