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西班牙真实环境下的化疗所致恶心呕吐的预防。

Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain.

机构信息

Department of Medical Oncology, Gregorio Marañón University General Hospital, C/ Dr. Esquerdo, 46, 28007, Madrid, Spain.

Department of Medical Oncology, La Paz University Hospital, Madrid, Spain.

出版信息

Clin Transl Oncol. 2021 Oct;23(10):2155-2162. doi: 10.1007/s12094-021-02623-8. Epub 2021 May 6.

Abstract

PURPOSE

Proper monitoring and management of chemotherapy-induced nausea and vomiting (CINV) with antiemetics is crucial for cancer patients. This study aimed to evaluate the use of antiemetics for the treatment of highly emetogenic chemotherapy (HEC) including carboplatin in the real-world setting in Spain.

METHODS

A representative panel of cancer specialists was asked to collect information about the antiemetic treatments provided to patients receiving chemotherapy. Records formed part of the Global Oncology Monitor database (Ipsos Healthcare, London, UK). Chemotherapy data were extrapolated using Ipsos Healthcare's projection methodology.

RESULTS

A total of 73 experts were finally included. Data from 9519 patients, estimated to be representative of 202,084 patients, were collected. HEC (and carboplatin-based chemotherapy) was administered to 73,118 (36%) patients, cisplatin-based therapy being the most frequent treatment (n = 34,649, 47.38%). Neurokinin-1 receptor antagonists (NKRAs) alone or in combination were used as prophylaxis for CINV in 14,762 (20%) patients, while the combination of NKRA with 5-hydroxytryptamine-3 receptor antagonist (5-HTRAs) and dexamethasone as recommended by the international guidelines was used in 5849 (8%) patients only. No antiemetic prophylaxis was administered to 8.46% of the patients receiving HEC (n = 6189). Physicians classified cisplatin-, anthracycline-cyclophosphamide (AC-), and carboplatin-based regimens as HEC in 63%, 22% and 4% of the cases, respectively.

CONCLUSIONS

The use of NKRA-containing regimens for CINV prevention in patients treated with HEC was less than expected, suggesting poor adherence to international antiemetic guidelines.

摘要

目的

使用止吐药对化疗引起的恶心和呕吐(CINV)进行适当的监测和管理对癌症患者至关重要。本研究旨在评估在西班牙的真实环境中使用止吐药治疗高致吐性化疗(HEC),包括卡铂。

方法

一组代表性的癌症专家被要求收集接受化疗的患者接受止吐治疗的信息。记录构成了全球肿瘤监测数据库(Ipsos Healthcare,伦敦,英国)的一部分。化疗数据使用 Ipsos Healthcare 的预测方法进行推断。

结果

最终有 73 名专家参与。共收集了 9519 名患者的数据,估计代表了 202084 名患者。73118 名(36%)患者接受了 HEC(包括卡铂为基础的化疗),顺铂为基础的治疗是最常见的治疗方法(n=34649,47.38%)。神经激肽-1 受体拮抗剂(NKRAs)单独或联合用于预防 CINV 在 14762 名(20%)患者中,而根据国际指南推荐的 NKRAs 联合 5-羟色胺-3 受体拮抗剂(5-HTRAs)和地塞米松仅在 5849 名(8%)患者中使用。8.46%接受 HEC 的患者(n=6189)未接受任何止吐预防。医生将顺铂、蒽环类环磷酰胺(AC)和卡铂为基础的方案分别归类为 HEC 的 63%、22%和 4%。

结论

在接受 HEC 治疗的患者中,使用包含 NKRAs 的方案预防 CINV 的情况低于预期,表明国际止吐指南的依从性较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11de/8390393/d999ba4bfe9a/12094_2021_2623_Fig1_HTML.jpg

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