Kaito Daizo, Iihara Hirotoshi, Funaguchi Norihiko, Endo Junki, Ito Fumitaka, Yanase Komei, Toyoshi Sayaka, Sasaki Yuka, Hirose Chiemi, Arai Natsumi, Kitahora Mika, Ohno Yasushi, Itoh Yoshinori, Minatoguchi Shinya
Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Anticancer Res. 2017 Apr;37(4):1965-1970. doi: 10.21873/anticanres.11537.
Carboplatin (CBDCA) is known to exhibit a high emetic risk among moderate-emetic risk anticancer drugs, and the dose of CBDCA varies in different therapies. In concurrent chemoradiotherapy (CCRT) for non-small cell lung cancer (NSCLC), the weekly administration of CBDCA (area under the curve (AUC) 2 mg/ml/min) and paclitaxel (PTX: 40 mg/m) is frequently applied as standard therapy. However, the optimal antiemetic measures in the use of such low-dose CBDCA remain unclear. In this study, we retrospectively assessed the antiemetic effect of a single-dose of a first-generation 5-hydroxytryptamine-3 receptor antagonist (5-HTRA) and dexamethasone in the weekly CBDCA+PTX therapy in CCRT.
The subjects were patients with NSCLC who were administered weekly CBDCA+PTX therapy in CCRT between January 2011 and December 2016 at our Department. As an antiemetic measure, a first-generation 5-HTRA, azasetron (10 mg, orally) or granisetron (3 mg, intravenously), and dexamethasone (9.9 mg, intravenously) were administered on day 1. The patients were evaluated for the following efficacy end-points for the first cycle: Complete response (CR; defined as no vomiting or retching episodes with no rescue medication) in the acute phase (0-24 hours), delayed phase (>24-120 hours), and overall phase (0-120 hours). Other efficacy endpoints evaluated were no vomiting or retching, and no nausea in all phases.
The subjects we assessed in this study were 46 patients who were administered weekly CBDCA+PTX therapy in CCRT. For the overall, acute, and delayed phases, the complete response rates were 89.1%, 100%, and 89.1%, respectively. The rate of no nausea in the overall, acute, and delayed phases was 78.3%, 100%, and 78.3%, respectively. The rate of no vomiting in the overall, acute, and delayed phases was 95.7%, 100%, and 95.7%, respectively.
A single dose of a first-generation 5-HTRA and dexamethasone had a favorable suppressive effect on nausea and vomiting in weekly CBDCA+PTX therapy for NSCLC.
在中度致吐风险的抗癌药物中，卡铂（CBDCA）的致吐风险较高，且不同治疗方案中CBDCA的剂量有所不同。在非小细胞肺癌（NSCLC）的同步放化疗（CCRT）中，每周给予CBDCA（曲线下面积（AUC）2mg/ml/min）和紫杉醇（PTX：40mg/m²）是常用的标准治疗方案。然而，使用这种低剂量CBDCA时的最佳止吐措施仍不明确。在本研究中，我们回顾性评估了第一代5-羟色胺-3受体拮抗剂（5-HTRA）和地塞米松单剂量在CCRT中每周CBDCA+PTX治疗的止吐效果。
研究对象为2011年1月至2016年12月在我科接受CCRT中每周CBDCA+PTX治疗的NSCLC患者。作为止吐措施，在第1天给予第一代5-HTRA阿扎司琼（10mg，口服）或格拉司琼（3mg，静脉注射）以及地塞米松（9.9mg，静脉注射）。对患者第一个周期的以下疗效终点进行评估：急性期（0 - 24小时）、延迟期（>24 - 120小时）和全期（0 - 120小时）的完全缓解（CR；定义为无呕吐或干呕发作且未使用救援药物）。评估的其他疗效终点为各阶段均无呕吐或干呕以及无恶心。
本研究评估的对象为46例在CCRT中接受每周CBDCA+PTX治疗的患者。全期、急性期和延迟期的完全缓解率分别为89.1%、100%和89.1%。全期、急性期和延迟期无恶心的发生率分别为78.3%、100%和78.3%。全期、急性期和延迟期无呕吐的发生率分别为95.7%、100%和95.7%。
第一代5-HTRA和地塞米松单剂量对NSCLC每周CBDCA+PTX治疗中的恶心和呕吐有良好的抑制作用。
