Timaeus Sarah, Elder Joshua, Franco Kyle
Norton Children's Hospital, Louisville, KY.
J Pediatr Hematol Oncol. 2018 Oct;40(7):527-531. doi: 10.1097/MPH.0000000000001213.
A neurokinin-1 (NK1) receptor antagonist is recommended with a 5-HT3 receptor antagonist and dexamethasone for prevention of chemotherapy-induced nausea and vomiting (CINV) in adult patients receiving highly emetogenic chemotherapy. Data for fosaprepitant use in pediatric patients is lacking. A retrospective chart review was conducted using an electronic medical record to characterize the use of fosaprepitant in patients aged 10 months to 18 years at a single institution from August 2015 to January 2017. Thirty-nine patients received fosaprepitant 4 mg/kg (maximum, 150 mg) for prevention of CINV, and 35 were included in the analysis. Ten patients 5 years of age or older who received fosaprepitant after October 2016 were eligible for a follow-up phone call to assess control of delayed CINV. Complete control of emesis was observed in 89% of patients during the acute phase, 63% during the delayed phase, and 60% overall. Overall incidence of nausea as documented in the medical record was 43%. Among the 10 patients who completed follow-up phone calls, 30% experienced emesis and 50% experienced nausea after discharge. Fosaprepitant may be safe and effective in the prevention of CINV in pediatric patients as young as 10 months of age.
对于接受高致吐性化疗的成年患者，推荐使用神经激肽-1（NK1）受体拮抗剂联合5-羟色胺3（5-HT3）受体拮抗剂和地塞米松来预防化疗引起的恶心和呕吐（CINV）。目前缺乏小儿患者使用磷丙泊酚的相关数据。本研究通过回顾性病历分析，利用电子病历对2015年8月至2017年1月期间在某单一机构就诊的10个月至18岁患者使用磷丙泊酚的情况进行了分析。39例患者接受了4mg/kg（最大剂量150mg）的磷丙泊酚以预防CINV，其中35例纳入分析。2016年10月后接受磷丙泊酚治疗的10例5岁及以上患者接受了随访电话，以评估延迟性CINV的控制情况。急性期呕吐完全控制率为89%，延迟期为63%，总体为60%。病历记录的恶心总体发生率为43%。在完成随访电话的10例患者中，30%在出院后出现呕吐，50%出现恶心。磷丙泊酚在预防低至10个月大的小儿患者CINV方面可能是安全有效的。
