Tsujii T, Tari K, Yonese J, Kojima S
Dept. of Urology, Saitama Cancer Center.
Gan To Kagaku Ryoho. 1988 Jul;15(7):2101-5.
As we already reported, timiperone, a new neuroleptic agent of the butyrophenone group, has a strong antiemetic effect against cisplatin (CDDP)-induced emesis. With timiperone 6 mg/day p.o. from the day before undergoing CDDP therapy to the last day of the therapy, non-vomiting rate was 80%. The most unfavorable adverse effect of this regimen was extrapyramidal symptoms which appear in almost 100% of the patients aged under forty-five. In this study, we attempted to reduce the dose of timiperone and its adverse effect in combination with low-dose methylprednisolone (MPL). Seventeen cases of urological malignancies with a 5-day course of CDDP (15 approximately 25 mg/m2) including anticancer therapy were entered in this open trial. Four cases aged under forty-five were given timiperone 1.5 mg/day p.o. from the day before undergoing CDDP therapy with MPL 125 mg i.v. immediately before CDDP was administered. Thirteen cases aged over forty-five were given timiperone 3.0 mg/day p.o. with MPL given in the same way. Non-vomiting rates were 47 and 79%, respectively. Extrapyramidal symptoms were seen in two cases of both groups. It was concluded that timiperone 3.0 mg with MPL 125 mg has an antiemetic efficacy comparable to that of timiperone 6.0 mg but with less adverse effects.
正如我们之前所报道的，替米哌隆是一种丁酰苯类新型抗精神病药物，对顺铂（CDDP）引起的呕吐具有很强的止吐作用。从接受CDDP治疗的前一天到治疗的最后一天，口服替米哌隆6mg/天，无呕吐率为80%。该治疗方案最不利的副作用是锥体外系症状，几乎在所有45岁以下的患者中出现。在本研究中，我们试图减少替米哌隆的剂量及其与低剂量甲基泼尼松龙（MPL）联合使用时的副作用。17例患有泌尿系统恶性肿瘤且接受为期5天的CDDP（15至25mg/m²）抗癌治疗的患者进入了这项开放试验。4例45岁以下的患者从接受CDDP治疗的前一天开始口服替米哌隆1.5mg/天，并在给予CDDP前立即静脉注射MPL 125mg。13例45岁以上的患者口服替米哌隆3.0mg/天，MPL给药方式相同。无呕吐率分别为47%和79%。两组均有2例出现锥体外系症状。得出的结论是，3.0mg替米哌隆与125mg MPL联合使用具有与6.0mg替米哌隆相当的止吐效果，但副作用更少。
