Shiu W, Tsang V, Lam Y M, Zacharia A, Martin W M
Department of Clinical Oncology, Chinese University of Hong Kong, Shatin, N. T.
Cancer Chemother Pharmacol. 1987;20(3):259-62. doi: 10.1007/BF00570498.
Nineteen Chinese patients receiving chemotherapy for advanced cancer were studied for chemotherapy-induced acute nausea and vomiting. The chemotherapy consisted of cisplatinum 100 mg/m2 i.v. infusion over 4 h on day 1 and 5-fluorouracil (5-FU) 1000 mg/m2 120-h continuous infusion from day 2 to day 6, repeated every 3 weeks. At the first course of chemotherapy the patients were randomized to receive either low-dose metoclopramide and chlorpromazine or high-dose metoclopramide, and then crossed over for the second course. In the high-dose metoclopramide group there was a suggestion of an earlier onset of emesis, with slightly more frequent retching and vomiting and less food consumed. However, the duration of emesis was shorter in the high-dose group. These differences were not statistically significant. There were no major side effects. Mild salutary drowsiness was noticed in patients receiving low-dose metoclopramide and chlorpromazine. This trial suggests that, in the dosage, route and schedule described, high-dose metoclopramide is no more effective than low-dose metoclopramide together with chlorpromazine in preventing cisplatinum-induced nausea and vomiting. The low-dose scheme is more economic and suitable for patients with advanced cancer.
对19名接受晚期癌症化疗的中国患者进行了化疗引起的急性恶心和呕吐的研究。化疗方案为第1天静脉输注顺铂100mg/m²，持续4小时，第2天至第6天持续静脉输注氟尿嘧啶（5-FU）1000mg/m²，持续120小时，每3周重复一次。在第一个化疗疗程中，患者被随机分为接受低剂量甲氧氯普胺和氯丙嗪组或高剂量甲氧氯普胺组，然后在第二个疗程时交叉用药。在高剂量甲氧氯普胺组中，有呕吐发作较早的迹象，干呕和呕吐更为频繁，进食量较少。然而，高剂量组的呕吐持续时间较短。这些差异无统计学意义。未出现严重副作用。接受低剂量甲氧氯普胺和氯丙嗪的患者出现了轻度有益的嗜睡。该试验表明，在所描述的剂量、途径和疗程中，高剂量甲氧氯普胺在预防顺铂引起的恶心和呕吐方面并不比低剂量甲氧氯普胺联合氯丙嗪更有效。低剂量方案更经济，适合晚期癌症患者。
