Abe Masakazu, Kasamatsu Yuka, Kado Nobuhiro, Kuji Shiho, Tanaka Aki, Takahashi Nobutaka, Takekuma Munetaka, Hirashima Yasuyuki
Division of Gynecology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.
Biomed Res Int. 2015;2015:956785. doi: 10.1155/2015/956785. Epub 2015 Sep 3.
Olanzapine is proved to be effective for chemotherapy induced nausea and vomiting (CINV). But its efficacy in combination with standard antiemetic therapy is unknown. The purpose of this study is to prove the preventive effect of olanzapine for the prevention of CINV caused by highly emetogenic chemotherapy when used with standard antiemetic therapy.
Gynecologic cancer patients receiving cisplatin-based chemotherapy who had grade 2 or 3 nausea in overall phase (0-120 h after chemotherapy) despite standard therapy were assigned to this study. From the next cycles to cycles in which patients developed grade 2 or 3 nausea, they received olanzapine with standard therapy. 5 mg oral olanzapine was administered for 7 days from the day before chemotherapy. The effectiveness of preventive administration of olanzapine was evaluated retrospectively. The primary endpoint was nausea control rate (grade 0 or 1) with olanzapine.
Fifty patients were evaluable. The nausea control rate with olanzapine was improved from 58% to 98% in acute phase (0-24 h after chemotherapy) and 2% to 94% in delayed phase (24-120 h after chemotherapy). In overall phase, the nausea control rate improved from 0% to 92%, and it was statistically significant (P < 0.001).
Preventive use of olanzapine combined with standard antiemetic therapy showed improvement in control of refractory nausea.
已证实奥氮平对化疗引起的恶心和呕吐（CINV）有效。但其与标准止吐疗法联合使用时的疗效尚不清楚。本研究的目的是证明奥氮平与标准止吐疗法联合使用时对预防高致吐性化疗引起的CINV的预防作用。
接受以顺铂为基础化疗的妇科癌症患者，尽管接受了标准治疗，但在整个阶段（化疗后0 - 120小时）出现2级或3级恶心，被纳入本研究。从下一个周期到患者出现2级或3级恶心的周期，他们接受奥氮平与标准疗法。从化疗前一天开始口服5mg奥氮平，持续7天。回顾性评估奥氮平预防性给药的有效性。主要终点是奥氮平的恶心控制率（0级或1级）。
50例患者可评估。奥氮平在急性期（化疗后0 - 24小时）的恶心控制率从58%提高到98%，在延迟期（化疗后24 - 120小时）从2%提高到94%。在整个阶段，恶心控制率从0%提高到92%，差异有统计学意义（P < 0.001）。
奥氮平与标准止吐疗法联合预防性使用可改善难治性恶心的控制。
