Marty M
Service d'Oncologie Medicale, Hôpital St Louis, Paris, France.
Eur J Cancer Clin Oncol. 1989;25 Suppl 1:S41-5.
Nausea and vomiting occur in all patients following high-dose cisplatin chemotherapy, unless an effective anti-emetic is administered. Early clinical studies therefore examined ondansetron treatment to establish an optimal dosing schedule for acute emesis. Pilot studies suggested that a daily dose of 32 mg ondansetron, given as a continuous intravenous infusion or intermittently on a mg/kg basis, gives optimum control of emesis, and was therefore selected for comparative studies. Efficacy was confirmed in two randomised, double-blind, crossover studies comparing ondansetron and metoclopramide. Ondansetron was superior to high-dose metoclopramide in controlling acute emesis and nausea, and there was a significant patient preference for ondansetron. These effects may be related to ondansetron's greater potency as a competitive 5-HT3 antagonist. In addition, ondansetron did not induce any extrapyramidal reactions, confirming the absence of any dopamine antagonist activity.
所有接受大剂量顺铂化疗的患者都会出现恶心和呕吐，除非给予有效的止吐药。因此，早期临床研究对昂丹司琼治疗进行了检查，以确定急性呕吐的最佳给药方案。初步研究表明，每日32毫克昂丹司琼剂量，以持续静脉输注或按毫克/千克间歇给药，能最佳控制呕吐，因此被选用于比较研究。在两项比较昂丹司琼和甲氧氯普胺的随机、双盲、交叉研究中证实了其疗效。昂丹司琼在控制急性呕吐和恶心方面优于大剂量甲氧氯普胺，并且患者对昂丹司琼有明显的偏好。这些作用可能与昂丹司琼作为竞争性5-HT3拮抗剂的更强效力有关。此外，昂丹司琼未引起任何锥体外系反应，证实其无任何多巴胺拮抗剂活性。
