Pastorelli Davide, Locatelli Maria Adelia, Melotti Barbara, Pisano Carmela, Turano Salvatore, Mellino Umberto, Provinciali Nicoletta, Marchetti Paolo, Dazzi Claudio, Berretta Massimiliano, Giordano Anna, Lorusso Vito
Istituto Oncologico Veneto, IRCCS, Padova, Italy.
J Chemother. 2013 Oct;25(5):309-17. doi: 10.1179/1973947813Y.0000000118.
Data from a large European prospective observational study were analysed to describe the antiemetic prescribing pattern for chemotherapy-induced nausea and vomiting (CINV) in Italian clinical practice.
Post hoc analysis of the Pan European Emesis Registry in chemo-naïve adults initiating single-day highly or moderately emetogenic chemotherapy (HEC or MEC) for cancer.
A total of 211 eligible patients were enrolled in the Italian centres, 180 were included in the analyses for cycle 1; 50·6% received MEC. The use of guideline-consistent CINV prophylaxis (GCCP) varied substantially between acute and delayed phases (54·4% during the acute phase vs. 29·4% in the overall 120-hour study period, acute plus delayed phases). Neurokinin-1 receptor antagonist was added to the prophylaxis with dexamethasone+5-hydroxytryptamine type 3 receptor antagonists in only 11·1% of patients (vs. 57·2% of the entire European study population). In the GCCP group, the complete response rate was significantly higher than that recorded in the guideline-inconsistent CINV prophylaxis (GICP) group (75·5 vs. 53·5%, P = 0·006).
The proportion of guideline-consistent antiemetic therapy was quite low in the Italian population as it was in the overall European population. The implementation of specific guidelines' recommendations for chemotherapeutic regimens administered according to standard protocols could be considered as a means to reduce the burden of CINV.
分析一项大型欧洲前瞻性观察性研究的数据，以描述意大利临床实践中化疗引起的恶心和呕吐（CINV）的止吐药处方模式。
对初治成人癌症患者进行单日高致吐性或中度致吐性化疗（HEC或MEC）的泛欧洲呕吐登记进行事后分析。
意大利中心共纳入211例符合条件的患者，180例纳入第1周期分析；50.6%接受MEC。指南一致的CINV预防（GCCP）在急性期和延迟期的使用差异很大（急性期为54.4%，而在整个120小时研究期，即急性期加延迟期为29.4%）。仅11.1%的患者在预防中添加了神经激肽-1受体拮抗剂与地塞米松+5-羟色胺3型受体拮抗剂（而整个欧洲研究人群为57.2%）。在GCCP组中，完全缓解率显著高于指南不一致的CINV预防（GICP）组（75.5%对53.5%，P = 0.006）。
与整个欧洲人群一样，意大利人群中指南一致的止吐治疗比例相当低。根据标准方案实施针对化疗方案的特定指南建议可被视为减轻CINV负担的一种手段。
