Sridhar K S, Donnelly E
Papanicolaou Comprehensive Cancer Center, Department of Oncology, University of Miami School of Medicine, Jackson Memorial Hospital, FL 33101.
Cancer. 1988 Apr 15;61(8):1508-17. doi: 10.1002/1097-0142(19880415)61:8<1508::aid-cncr2820610806>3.0.co;2-h.
Nausea and vomiting occur in a majority of patients receiving cisplatin chemotherapy despite prophylactic single agent antiemetic therapy. Three potent antiemetics, metoclopramide, droperidol and dexamethasone, and diphenhydramine to prevent potential extrapyramidal reactions, were combined in prophylaxis of 67 patients receiving cisplatin chemotherapy. Of the patients studied, 76.1% experienced complete protection from both nausea and vomiting in their first course and 62.7% in all their courses of treatment. In 73.3% of 161 evaluable courses, there was neither nausea nor vomiting. Vomiting did not occur in 79.5% of courses. There was no evidence to suggest tachyphylaxis. The efficacy in preventing nausea and vomiting was independent of primary disease site, age, sex, performance status, prior chemotherapy, and prior vomiting. Toxicities were mild and infrequent. Reversible transient extrapyramidal reactions, sweating or twitches occurred in 5.6% of courses. The combination of metoclopramide, diphenhydramine, droperidol and dexamethasone was highly efficacious in preventing nausea and vomiting in moderate or high-dose cisplatin chemotherapy with little toxicity.
尽管采用了预防性单药止吐治疗，但大多数接受顺铂化疗的患者仍会出现恶心和呕吐。将三种强效止吐药甲氧氯普胺、氟哌利多和地塞米松，以及用于预防潜在锥体外系反应的苯海拉明联合用于67例接受顺铂化疗患者的预防治疗。在研究的患者中，76.1%在首个疗程中恶心和呕吐均得到完全预防，在所有疗程中这一比例为62.7%。在161个可评估疗程中，73.3%既无恶心也无呕吐。79.5%的疗程未发生呕吐。没有证据表明存在快速耐受性。预防恶心和呕吐的疗效与原发疾病部位、年龄、性别、体能状态、既往化疗及既往呕吐情况无关。毒性轻微且不常见。5.6%的疗程出现可逆性短暂锥体外系反应、出汗或抽搐。甲氧氯普胺、苯海拉明、氟哌利多和地塞米松联合使用在预防中高剂量顺铂化疗引起的恶心和呕吐方面疗效显著，且毒性较小。
