Department of Gastroenterological Surgery, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan,
J Gastroenterol. 2013 Nov;48(11):1234-41. doi: 10.1007/s00535-012-0746-1. Epub 2013 Jan 22.
We aimed to evaluate the efficacy of a new combination antiemetic therapy comprising aprepitant, granisetron, and dexamethasone in gastric cancer patients undergoing chemotherapy with cisplatin and S-1.
Gastric cancer patients scheduled to receive their first course of chemotherapy with cisplatin (60 mg/m(2)) and S-1 (80 mg/m(2)) were treated with a new combination antiemetic therapy aprepitant, granisetron, and dexamethasone on day 1; aprepitant and dexamethasone on days 2 and 3; and dexamethasone on day 4. The patients reported vomiting, nausea, use of rescue therapy, and change in the amount of diet intake, and completed the Functional Living Index-Emesis (FLIE) questionnaire. The primary endpoint was complete response (CR; no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after cisplatin administration). The secondary endpoints included complete protection (CP; CR plus no significant nausea); change in the amount of diet intake; and the impact of chemotherapy-induced nausea and vomiting (CINV) on daily life during the overall, acute (0-24 h), and delayed (24-120 h) phases.
Fifty-three patients were included. CR was achieved in 88.7, 98.1, and 88.7% of patients in the overall, acute, and delayed phases, respectively. The corresponding rates of CP were 67.9, 96.2, and 67.9%. Approximately half of the patients had some degree of anorexia. FLIE results indicated that 79.5% of patients reported "minimal or no impact of CINV on daily life".
Addition of aprepitant to standard antiemetic therapy was effective in gastric cancer patients undergoing treatment with cisplatin and S-1.
我们旨在评估一种新的包含阿瑞匹坦、格拉司琼和地塞米松的止吐联合方案在接受顺铂和 S-1 化疗的胃癌患者中的疗效。
计划接受顺铂（60mg/m²）和 S-1（80mg/m²）首次化疗的胃癌患者在第 1 天接受新的止吐联合方案（阿瑞匹坦、格拉司琼和地塞米松）；第 2 天和第 3 天给予阿瑞匹坦和地塞米松；第 4 天给予地塞米松。患者报告呕吐、恶心、使用解救治疗和饮食摄入变化，并完成功能生活指数-呕吐（FLIE）问卷。主要终点是整个研究阶段（顺铂给药后 0-120 小时）的完全缓解（CR；无呕吐且未使用解救止吐药）。次要终点包括完全保护（CP；CR 加上无明显恶心）；饮食摄入变化；以及整个、急性（0-24 小时）和延迟（24-120 小时）阶段化疗引起的恶心和呕吐（CINV）对日常生活的影响。
共纳入 53 例患者。在整个、急性和延迟阶段，CR 分别达到 88.7%、98.1%和 88.7%。相应的 CP 率分别为 67.9%、96.2%和 67.9%。约一半的患者有一定程度的厌食。FLIE 结果表明，79.5%的患者报告“CINV 对日常生活几乎没有影响或没有影响”。
在接受顺铂和 S-1 治疗的胃癌患者中，阿瑞匹坦联合标准止吐治疗有效。
