Georgia Cancer Specialists, Atlanta, GA, USA.
Support Care Cancer. 2012 Mar;20(3):615-23. doi: 10.1007/s00520-011-1140-x. Epub 2011 Mar 29.
The purpose of this study is to examine the risk of uncontrolled chemotherapy-induced nausea/vomiting (CINV) among lung cancer patients receiving multi-day chemotherapy and ondansetron- or palonosetron-initiated prophylactic antiemetic regimens in a community oncology setting.
The Georgia Cancer Specialists electronic medical records database was used to retrospectively identify lung cancer patients who received multi-day cisplatin or carboplatin regimens with ondansetron or palonosetron on day 1 between April 1, 2006 and July 31, 2009. Uncontrolled CINV events were identified through ICD-9-CM codes (nausea/vomiting), CPT codes (dehydration), rescue medications, nausea/vomiting hospitalizations, and/or antiemetic therapy after last chemotherapy administration of the cycle. Risk for uncontrolled CINV, up to 7 days after last chemotherapy administration, was analyzed at cycle level using logistic regression with regressors of gender, age, number of chemotherapy administration days, Charlson comorbidity index, cancer type, multicancer diagnoses, and chemotherapy regimen.
A total of 209 palonosetron and 153 ondansetron patients (702 and 515 cycles, respectively) met the inclusion criteria. Palonosetron patients were significantly older (mean 67.9 versus 63.9 years; P < 0.0001), with no significant difference in gender, baseline comorbidity score, or multicancer diagnosis. Palonosetron cycles had 63% lower risk for uncontrolled CINV events versus ondansetron cycles [odds ratio (OR) 0.37; 95% confidence interval (CI) 0.25-0.54; P < 0.0001]. Sub-analysis by chemotherapy supported overall analysis (cisplatin OR 0.09; 95% CI 0.04-0.25; P < 0.0001; carboplatin OR 0.46; 95% CI 0.30-0.70; P = 0.0003).
In this retrospective analysis of lung cancer patients, multi-day chemotherapy cycles administered with palonosetron on day 1 were associated with a significantly lower risk for uncontrolled CINV events versus ondansetron-initiated chemotherapy cycles.
本研究旨在探讨在社区肿瘤学环境中，接受多日化疗且使用昂丹司琼或帕洛诺司琼进行预防性止吐治疗的肺癌患者中，无控制的化疗引起的恶心/呕吐（CINV）风险。
本研究使用佐治亚癌症专家电子病历数据库，回顾性地确定了 2006 年 4 月 1 日至 2009 年 7 月 31 日期间接受多日顺铂或卡铂联合昂丹司琼或帕洛诺司琼（第 1 天）治疗的肺癌患者。通过 ICD-9-CM 代码（恶心/呕吐）、CPT 代码（脱水）、解救药物、恶心/呕吐住院治疗和/或周期末次化疗后止吐治疗来确定未控制的 CINV 事件。使用逻辑回归分析在周期水平上分析无控制的 CINV 风险，回归因子包括性别、年龄、化疗天数、Charlson 合并症指数、癌症类型、多癌诊断和化疗方案。
共有 209 例帕洛诺司琼和 153 例昂丹司琼患者（分别为 702 例和 515 例周期）符合纳入标准。帕洛诺司琼患者明显更年长（平均 67.9 岁比 63.9 岁；P<0.0001），但性别、基线合并症评分或多癌诊断无显著差异。与昂丹司琼周期相比，帕洛诺司琼周期发生无控制的 CINV 事件的风险降低了 63%[比值比（OR）0.37；95%置信区间（CI）0.25-0.54；P<0.0001]。化疗支持亚分析支持总体分析（顺铂 OR 0.09；95%CI 0.04-0.25；P<0.0001；卡铂 OR 0.46；95%CI 0.30-0.70；P=0.0003）。
在这项对肺癌患者的回顾性分析中，与昂丹司琼起始的化疗周期相比，第 1 天给予帕洛诺司琼的多日化疗周期与无控制的 CINV 事件风险显著降低相关。
