帕洛诺司琼与其他 5-羟色胺 5-HT3 受体拮抗剂在多日高致吐性化疗中三联止吐方案中的疗效。

Effectiveness of palonosetron versus other serotonin 5-HT3 receptor antagonists in triple antiemetic regimens during multiday highly emetogenic chemotherapy.

机构信息

College of Pharmacy, Seoul National University, Seoul, Korea.

出版信息

Ann Pharmacother. 2012 Dec;46(12):1637-44. doi: 10.1345/aph.1R396. Epub 2012 Nov 20.

DOI:10.1345/aph.1R396

PMID:23170032

Abstract

BACKGROUND

The second-generation serotonin 5-HT(3) receptor antagonist palonosetron has shown improved efficacy in the prevention of both acute and delayed chemotherapy-induced nausea and vomiting (CINV). However, there have been no randomized controlled trials supporting the preferential use of palonosetron in triple antiemetic regimens for patients receiving multiday highly emetogenic chemotherapy (HEC).

OBJECTIVE

To compare the effectiveness of palonosetron-based and first-generation 5-HT(3) receptor antagonist-based triple antiemetic regimens in cancer patients receiving multiday HEC.

METHODS

This was a review and analysis of medical record data. A total of 115 patients who had received multiday HEC were included and grouped into a palonosetron-based antiemetic group (n = 73) or a first-generation 5-HT(3) receptor antagonist-based antiemetic group (n = 42). Data on CINV were collected in 24-hour intervals for 120 hours after the start of chemotherapy.

RESULTS

Complete response rates did not differ significantly between the 2 groups during any of the 3 phases: acute (0-24 hours), p = 0.877; overlap (24-120 hours), p = 0.997; and overall (0-120 hours), p = 0.723. The proportion of patients with complete control was similar between the groups during each phase: acute, p = 0.862; overlap, p = 0.838; and overall, p = 0.828. There was also no significant difference in other end points between the 2 groups. Among all patients, females experienced significantly more acute nausea (p = 0.040) and vomiting (p = 0.046) than males. Compared with nondrinkers, patients who consumed alcohol had a lower overall incidence of vomiting (p = 0.020).

CONCLUSIONS

Within a triple antiemetic regimen, a palonosetron-based antiemetic regimen was not significantly different from regimens based on first-generation 5-HT(3) receptor antagonists in preventing CINV during multiday HEC.

摘要

背景

第二代 5-羟色胺（5-HT）3 受体拮抗剂帕洛诺司琼在预防急性和延迟性化疗引起的恶心和呕吐（CINV）方面显示出更好的疗效。然而，目前还没有随机对照试验支持在接受多日高致吐性化疗（HEC）的患者中，优先使用帕洛诺司琼的三联止吐方案。

目的

比较基于帕洛诺司琼和第一代 5-HT3 受体拮抗剂的三联止吐方案在接受多日 HEC 的癌症患者中的疗效。

方法

这是一项对病历数据的回顾性分析。共纳入 115 例接受多日 HEC 的患者，分为基于帕洛诺司琼的止吐组（n = 73）和第一代 5-HT3 受体拮抗剂的止吐组（n = 42）。在化疗开始后 120 小时内，每 24 小时收集一次 CINV 数据。

结果

两组在三个阶段的完全缓解率均无显著差异：急性（0-24 小时），p = 0.877；重叠期（24-120 小时），p = 0.997；总体（0-120 小时），p = 0.723。两组在每个阶段的完全控制比例相似：急性，p = 0.862；重叠期，p = 0.838；总体，p = 0.828。两组间其他终点也无显著差异。在所有患者中，女性在急性恶心（p = 0.040）和呕吐（p = 0.046）方面的发生率显著高于男性。与不饮酒者相比，饮酒者的总体呕吐发生率较低（p = 0.020）。