Sorbe B, Hallén C
Department of Gynecologic Oncology, Regionsjukhuset, Orebro, Sweden.
Acta Oncol. 1988;27(4):357-60. doi: 10.3109/02841868809093554.
In a prospective randomized and double-blind cross-over study betamethasone-dixyrazine was compared with metoclopramide as antiemetic treatment in cisplatin and doxorubicin chemotherapy. Sixty-two consecutive patients without prior experience of chemotherapy entered the study and were followed during 1-4 courses of treatment. Effect parameters were recorded on questionnaires using the visual analog scale for quantification. The median number of courses per patient was 3.0 (range 1-4). Full protection against nausea and vomiting was achieved in 74% with betamethasone-dixyrazine and in 45% with metoclopramide regardless of the chemotherapy regimen employed. With doxorubicin regimens betamethasone-dixyrazine gave full protection in 94% and metoclopramide in 45%. In cisplatin regimens full emetic protection was achieved in 40% with betamethasone-dixyrazine and in 29% with metoclopramide. Adverse reactions were a significant problem with metoclopramide: restlessness 48%, akathisia 26%, parkinsonism 13%, and acute dystonia 3%. One case (3.2%) of parkinsonism was noted as the only extrapyramidal reaction in the dixyrazine group. Various degrees of sedation were noted in 84% during dixyrazine treatment compared with 71% during metoclopramide therapy. Diarrhea was encountered in 48% after high-dose metoclopramide compared with 6% after antiemetic treatment with betamethasone-dixyrazine. Betamethasone-dixyrazine appears to be a promising antiemetic combination with regard to both efficacy and side effects, but further refinement of the regimen is probably possible through dose adjustments and alternative routes of administration.
在一项前瞻性随机双盲交叉研究中，对比了倍他米松-二乙嗪与甲氧氯普胺在顺铂和阿霉素化疗中作为止吐治疗的效果。62例此前无化疗经验的连续患者进入研究，并在1至4个疗程的治疗期间接受随访。使用视觉模拟量表通过问卷记录效果参数以进行量化。每位患者的疗程中位数为3.0（范围1 - 4）。无论采用何种化疗方案，倍他米松-二乙嗪对恶心和呕吐的完全防护率为74%，甲氧氯普胺为45%。在阿霉素治疗方案中，倍他米松-二乙嗪的完全防护率为94%，甲氧氯普胺为45%。在顺铂治疗方案中，倍他米松-二乙嗪的完全止吐防护率为40%，甲氧氯普胺为29%。不良反应方面，甲氧氯普胺是一个严重问题：不安48%、静坐不能26%、帕金森症13%、急性肌张力障碍3%。二乙嗪组仅记录到1例（3.2%）帕金森症作为唯一的锥体外系反应。二乙嗪治疗期间84%的患者出现不同程度的镇静，而甲氧氯普胺治疗期间为71%。大剂量甲氧氯普胺后48%的患者出现腹泻，而倍他米松-二乙嗪止吐治疗后为6%。就疗效和副作用而言，倍他米松-二乙嗪似乎是一种有前景的止吐组合，但通过调整剂量和改变给药途径可能进一步优化治疗方案。
