Zhao Yang, He MinKe, Liang RunBin, Li QiJiong, Shi Ming
Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
Ther Clin Risk Manag. 2021 Jan 22;17:73-77. doi: 10.2147/TCRM.S283192. eCollection 2021.
Our aim was to compare the antiemetic efficacy of the triple combination of aprepitant, dolasetron and dexamethasone with the combination of dolasetron and dexamethasone for chemotherapy-induced nausea and vomiting (CINV) in hepatocellular carcinoma (HCC) patients receiving hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin, fluorouracil and leucovorin (FOLFOX).
This was a retrospective study. In the dolasetron plus dexamethasone group (D group), the patients received dolasetron (100 mg, i.v., on day 1) and dexamethasone (10 mg, i.v., on day 1) 30 min before starting administration of chemotherapeutic drugs. In the aprepitant plus dolasetron and dexamethasone group (AD group), the patients received dolasetron and dexamethasone as described above, and aprepitant (125 mg, p.o.) on day 1 followed by 80 mg on days 2 and 3. The primary endpoint was the complete response rate (CR, defined as no emetic episodes and no rescue medication use) during the first cycle of hepatic arterial infusion chemotherapy.
Between January 2018 and August 2019, 302 eligible patients were included: 197 in AD group and 105 in D group. Patients in AD group had significantly higher complete response rates than those in D group during the first cycle (85.8% vs 71.4%, P = 0.003) and all cycles (73.6% vs 49.5%, P<0.001). Patients in AD group had lower rescue therapy (1.5% vs 26.7%, P<0.001) and lower incidence of disruption related to chemotherapy-induced nausea and vomiting (0.5% vs 6.7%, P = 0.002) than patients in D group.
Aprepitant, dolasetron plus dexamethasone is more effective to prevent chemotherapy-induced nausea and vomiting in hepatocellular carcinoma patients treated with FOLFOX-HAIC therapy than dolasetron plus dexamethasone.
我们的目的是比较阿瑞匹坦、多拉司琼和地塞米松三联组合与多拉司琼和地塞米松组合对接受奥沙利铂、氟尿嘧啶和亚叶酸钙（FOLFOX）肝动脉灌注化疗（HAIC）的肝细胞癌（HCC）患者化疗引起的恶心和呕吐（CINV）的止吐疗效。
这是一项回顾性研究。在多拉司琼加地塞米松组（D组）中，患者在开始化疗药物给药前30分钟接受多拉司琼（100毫克，静脉注射，第1天）和地塞米松（10毫克，静脉注射，第1天）。在阿瑞匹坦加多拉司琼和地塞米松组（AD组）中，患者按上述方法接受多拉司琼和地塞米松治疗，第1天口服阿瑞匹坦（125毫克），第2天和第3天口服80毫克。主要终点是肝动脉灌注化疗第一个周期的完全缓解率（CR，定义为无呕吐发作且未使用救援药物）。
2018年1月至2019年8月，纳入302例符合条件的患者：AD组197例，D组105例。AD组患者在第一个周期（85.8%对71.4%，P = 0.003）和所有周期（73.6%对49.5%，P<0.001）的完全缓解率显著高于D组。与D组患者相比，AD组患者的救援治疗较少（1.5%对26.7%，P<0.001），化疗引起的恶心和呕吐相关中断发生率较低（0.5%对6.7%，P = 0.002）。
对于接受FOLFOX-HAIC治疗的肝细胞癌患者，阿瑞匹坦、多拉司琼加地塞米松预防化疗引起的恶心和呕吐比多拉司琼加地塞米松更有效。
