Department of Hematology and Oncology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA.
Support Care Cancer. 2012 May;20(5):1043-7. doi: 10.1007/s00520-011-1180-2. Epub 2011 May 9.
This study sought to prospectively determine the frequency of delayed nausea and vomiting with oxaliplatin-based chemotherapy following day 1 prophylaxis with a 5-HT-(3) receptor antagonist and dexamethasone.
Patients with colon cancer, ≥ age 18, with a performance status ≤ 2, receiving oxaliplatin (85-100 mg/m(2)) as part of a standard folinic acid, 5-fluorouracil, oxaliplatin regimen for the first time were eligible. All patients received a 5-HT(3) receptor antagonist and dexamethasone 20 mg on day 1 prior to oxaliplatin. No routine prophylaxis for delayed emesis was given. Antiemetic outcome was recorded in patient-completed diaries for the 120-h study period following oxaliplatin administration. Primary endpoint was frequency of delayed (24-120 h) emesis (vomiting/retching).
Forty-one patients were enrolled and 39 are evaluable. Median age was 70 (34-85) and the female/male ratio was 20:19. Four patients (10%) experienced vomiting or retching during the delayed period. One patient vomited during the first 24 h after oxaliplatin. The overall (120 h) no emesis rate was 87% (34/39). Twenty-one patients (54%) developed delayed nausea. Nine patients had moderate or severe nausea. Eighteen patients (46%) took rescue antiemetics during the delayed period. Delayed and overall complete response (no emesis or use of rescue antiemetics) rates were 54% and 49%, respectively.
The use of a 5-HT(3) antagonist and dexamethasone prior to oxaliplatin results in excellent control of nausea and vomiting (CR-90%) during the 24 h after chemotherapy. However, without further antiemetic treatment, complete response in the delayed period decreased to 54%. This study supports the need for routine antiemetic prophylaxis for delayed nausea and vomiting following oxaliplatin-based chemotherapy.
本研究旨在前瞻性确定在第 1 天接受 5-HT-（3）受体拮抗剂和地塞米松预防后，接受奥沙利铂（85-100mg/m²）化疗的患者中延迟性恶心和呕吐的频率。
患有结肠癌的患者，年龄≥18 岁，表现状态≤2，首次接受奥沙利铂（奥沙利铂）作为标准亚叶酸、5-氟尿嘧啶、奥沙利铂方案的一部分。所有患者在奥沙利铂前一天（第 1 天）接受 5-HT-（3）受体拮抗剂和地塞米松 20mg。未给予常规延迟性呕吐预防。在奥沙利铂给药后 120 小时的研究期间，通过患者完成的日记记录止吐效果。主要终点是延迟（24-120 小时）呕吐（呕吐/干呕）的频率。
41 名患者入组，39 名可评估。中位年龄为 70 岁（34-85 岁），女性/男性比例为 20:19。4 名患者（10%）在延迟期出现呕吐或干呕。1 名患者在奥沙利铂后 24 小时内呕吐。总体（120 小时）无呕吐率为 87%（34/39）。21 名患者（54%）出现延迟性恶心。9 名患者有中度或重度恶心。18 名患者（46%）在延迟期使用了急救止吐药。延迟和总体完全缓解（无呕吐或使用急救止吐药）率分别为 54%和 49%。
在奥沙利铂之前使用 5-HT-（3）拮抗剂和地塞米松可极好地控制化疗后 24 小时内的恶心和呕吐（CR-90%）。然而，在没有进一步的止吐治疗的情况下，延迟期的完全缓解率下降至 54%。本研究支持奥沙利铂化疗后常规预防延迟性恶心和呕吐的需要。
