Dozono H, Yasuda M, Yokoyama S, Takahashi S, Ochiai K, Tsuruoka M, Morimoto O, Sasaki H, Arihiro T, Terashima Y
Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi. 1987 Nov;39(11):1968-72.
The dose limiting factors of cisplatinum are nephrotoxicity and emesis. Nephrotoxicity has been reduced by hydration but nausea and vomiting caused by cisplatinum have led to refusal of potentially curative therapy by a number of patients. The prevention of nausea and vomiting by a combination of antiemetic drugs administered to ovarian patients receiving chemotherapy inducing (cisplatinum 50mg/m2, adriamycin 300 mg/m2, cyclophosphamide 300 mg/m2 and 5FU 350 mg/m2) was studied. the combination antiemetic drugs were metoclopramide (1mg/kg), dexamethasone (10mg/m2), droperidol (1mg/m2) and diphenhydramine (20mg/body). These drugs without diphenhydramine were administered intravenously 30 minutes before and 2.5 hours, 5 hours and 7.5 hours after chemotherapy. Diphenhydramine was administered intramuscularly 30 minutes before and 5 hours after chemotherapy. No vomiting was noted in 82.6% (19/23) of cases, and no patient vomited more than four times. This combination regimen provided very good protection against cisplatinum induced emesis.
顺铂的剂量限制因素是肾毒性和呕吐。通过水化作用,肾毒性有所降低,但顺铂引起的恶心和呕吐导致许多患者拒绝接受可能治愈性的治疗。对接受诱导化疗(顺铂50mg/m²、阿霉素300mg/m²、环磷酰胺300mg/m²和5-氟尿嘧啶350mg/m²)的卵巢癌患者联合使用止吐药预防恶心和呕吐进行了研究。联合使用的止吐药为甲氧氯普胺(1mg/kg)、地塞米松(10mg/m²)、氟哌利多(1mg/m²)和苯海拉明(20mg/人)。不含苯海拉明的这些药物在化疗前30分钟以及化疗后2.5小时、5小时和7.5小时静脉给药。苯海拉明在化疗前30分钟和化疗后5小时肌肉注射。82.6%(19/23)的病例未出现呕吐,且没有患者呕吐超过4次。这种联合用药方案对顺铂引起的呕吐提供了很好的保护。