Chiara S, Campora E, Lionetto R, Bruzzi P, Rosso R
Am J Clin Oncol. 1987 Jun;10(3):264-7. doi: 10.1097/00000421-198706000-00021.
Sixty-eight breast cancer patients for outpatient adjuvant chemotherapy (CT) with cyclophosphamide, methotrexate, and fluorouracil (CMF) on a 1-day schedule entered a randomized trial comparing the antiemetic-efficacy of different doses of methylprednisolone (MPN). Treatment was administered concomitantly with the first course of CT and consisted of MPN in either 375 or 120-mg doses divided into 3 equal parts, the first administered i.v. just prior to CMF and then i.m. 6 and 12 h after CT. Overall, antiemetic protection was appreciable: complete emetic protection (no emetic episodes) was observed in 71 and 66% of patients receiving MPN 375 and 120 mg, respectively. In 43 and 54% of patients receiving MPN 375 and 120 mg, respectively, nausea did not occur. Efficacy of the two treatment arms was not statistically different for either emesis or nausea. Antiemetic protection with MPN was reproducible over time at subsequent courses: 60% of patients in either treatment arm experienced less than 5 emetic episodes at their 12th CMF course. Facial flush was the most frequently observed side effect (36% with MPN 120 mg vs. 68% with MPN 375 mg). Other acute untoward effects consisted of headache, pyrosis, and edema. However, the latter was observed only with the higher dose. In patients receiving CMF, MPN alone provides effective and reproducible emetic protection. No dose-response relationship was observed.
68例接受环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF）一日方案门诊辅助化疗的乳腺癌患者进入一项随机试验，比较不同剂量甲泼尼龙（MPN）的止吐疗效。治疗在首个化疗疗程时同时进行，包括375毫克或120毫克剂量的MPN，分为3等份，第一份在CMF化疗前静脉注射，然后在化疗后6小时和12小时肌肉注射。总体而言，止吐保护效果显著：分别在71%和66%接受375毫克和120毫克MPN的患者中观察到完全止吐保护（无呕吐发作）。分别在43%和54%接受375毫克和120毫克MPN的患者中未出现恶心。两个治疗组在呕吐或恶心方面的疗效无统计学差异。MPN的止吐保护在随后的疗程中可随时间重现：两个治疗组中60%的患者在第12次CMF疗程时呕吐发作少于5次。面部潮红是最常观察到的副作用（120毫克MPN组为36%，375毫克MPN组为68%）。其他急性不良反应包括头痛、烧心和水肿。然而，后者仅在高剂量时观察到。在接受CMF化疗的患者中，单独使用MPN可提供有效且可重现的止吐保护。未观察到剂量反应关系。
