Meattini Icro, Francolini Giulio, Scotti Vieri, De Luca Cardillo Carla, Cappelli Sabrina, Meacci Fiammetta, Furfaro Ilaria Francesca, Muntoni Cristina, Scoccianti Silvia, Detti Beatrice, Mangoni Monica, Nori Jacopo, Orzalesi Lorenzo, Fambrini Massimiliano, Bianchi Simonetta, Livi Lorenzo
Department of Radiation Oncology, University of Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy,
Med Oncol. 2015 Mar;32(3):80. doi: 10.1007/s12032-015-0535-9. Epub 2015 Feb 20.
The aim of our study was to evaluate the efficacy and safety of a three-drug antiemetic prophylaxis in a single-center series treated with anthracyclines and cyclophosphamide-based regimen for BC. We collected data from 92 consecutive patients treated with routine antiemetic prophylaxis consisted of aprepitant (oral 125 mg, on day 1; oral 80 mg, on days 2 and 3), a 5-HT3 receptor antagonist (palonosetron iv 0.25 mg, on day 1), and dexamethasone (iv 12 mg, on day 1). Acute and delayed phases were defined as the first 24 h and days 2-5 after treatment, respectively. Therapy outcomes were defined as complete response (CR), in case of no vomiting, no rescue treatment; complete protection (CP), in case of no vomiting, no rescue treatment, no significant nausea; and total control (TC), in case of no vomiting, no rescue treatment, no nausea. Overall, 89.1 and 81.5% of patients showed CR in acute and delayed phase, respectively; 67.4 and 62% showed CP in acute and delayed phase, respectively; and 52.2 and 48.9% of patients showed TC in acute and delayed phase, respectively. 4.3% complained an episode of emesis during the first 24 h from treatment, while in delayed phase, only 2.2% of patients had vomiting. Our analysis confirmed that a three-drug prophylaxis is safe, effective, and consequently highly recommended in patients who undergo anthracyclines and cyclophosphamide-based regimens, though still not classified as highly emetogenic chemotherapy by all the international guidelines.
我们研究的目的是评估在单中心系列接受以蒽环类药物和环磷酰胺为基础方案治疗乳腺癌的患者中，三联抗呕吐预防措施的疗效和安全性。我们收集了92例连续接受常规抗呕吐预防治疗患者的数据，该预防治疗方案包括阿瑞匹坦（第1天口服125 mg，第2天和第3天口服80 mg）、5-羟色胺3（5-HT3）受体拮抗剂（第1天静脉注射帕洛诺司琼0.25 mg）和地塞米松（第1天静脉注射12 mg）。急性期和延迟期分别定义为治疗后的前24小时和第2 - 5天。治疗结果定义为完全缓解（CR），即无呕吐、无需抢救治疗；完全保护（CP），即无呕吐、无需抢救治疗、无明显恶心；以及完全控制（TC），即无呕吐、无需抢救治疗、无恶心。总体而言，分别有89.1%和81.5%的患者在急性期和延迟期显示CR；分别有67.4%和62%的患者在急性期和延迟期显示CP；分别有52.2%和48.9%的患者在急性期和延迟期显示TC。4.3%的患者在治疗后的前24小时内出现一次呕吐，而在延迟期，只有2.2%的患者出现呕吐。我们的分析证实，三联预防措施是安全、有效的，因此强烈推荐用于接受以蒽环类药物和环磷酰胺为基础方案治疗的患者，尽管根据所有国际指南，该方案仍未被归类为高致吐性化疗。
