Osawa Hiroshi, Goto Hiroaki, Myojo Tomohiro
Dept. of Oncology and Hematology, Edogawa Hospital, Japan.
Gan To Kagaku Ryoho. 2013 May;40(5):617-21.
Nausea and vomiting are among the most problematic symptoms experienced by patients with cancer who are receiving chemotherapy. 5-hydroxytryptamine 3(5-HT3)-receptor antagonists, NK1 receptor antagonists(aprepitant)and dexamethasone are now the standard therapies for preventing chemotherapy-induced nausea and vomiting(CINV)that follow highly emetogenic chemotherapy, such as cisplatin and anthracycline. However, since it is not cleared which 5-HT3-recepter antagonist is a proper treatment for combined use with aprepitant and dexamethasone, we conducted a questionnaire survey, which used the numerical rating scale(NRS), for comparing palonosetron with granisetron in the same patient. Palonosetron showed a significant improvement of nausea for both acute(within 24 hours)and delayed phase(24-120 hours later), regardless of the type of chemotherapy(cisplatin or anthracycline-based regimen). Furthermore, palonosetron had a tolerable safety profile. Our study suggests that palonosetron-based antiemetic treatment will be a preferred choice for preventing CINV following highly emetogenic chemotherapy.
恶心和呕吐是接受化疗的癌症患者所经历的最棘手的症状之一。5-羟色胺3（5-HT3）受体拮抗剂、NK1受体拮抗剂（阿瑞匹坦）和地塞米松现在是预防顺铂和蒽环类药物等高致吐性化疗引起的化疗所致恶心和呕吐（CINV）的标准疗法。然而，由于尚不清楚哪种5-HT3受体拮抗剂适合与阿瑞匹坦和地塞米松联合使用，我们进行了一项问卷调查，使用数字评定量表（NRS），在同一患者中比较帕洛诺司琼和格拉司琼。无论化疗类型（顺铂或蒽环类方案）如何，帕洛诺司琼在急性期（24小时内）和延迟期（24-120小时后）均显示出恶心症状的显著改善。此外，帕洛诺司琼具有可耐受的安全性。我们的研究表明，基于帕洛诺司琼的止吐治疗将是预防高致吐性化疗后CINV的首选。
