Nakashima Kazuhisa, Harashima Saki, Kaneko Rena, Tanaka Ryuhei, Abe Masakazu, Wada Makoto, Iino Keiko, Akechi Tatsuo, Iihara Hirotoshi, Imamura Chiyo K, Okuyama Ayako, Ozawa Keiko, Kim Yong-Il, Satomi Eriko, Takeda Masayuki, Nakajima Takako Eguchi, Nakamura Naoki, Nishimura Junichi, Noda Mayumi, Hayashi Kazumi, Higashi Takahiro, Boku Narikazu, Matsumoto Koji, Matsumoto Yoko, Okita Kenji, Yamamoto Nobuyuki, Aogi Kenjiro, Sasaki Hidenori
Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan.
Department of Psychosomatic Medicine, Faculty of Medicine, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
Int J Clin Oncol. 2025 Jan;30(1):17-26. doi: 10.1007/s10147-024-02652-7. Epub 2024 Nov 12.
A standardized multi-day antiemetic regimen for multi-day chemotherapy remains elusive. This systematic review evaluated the efficacy and safety of multi-day antiemetic regimens in patients undergoing multi-day intravenous chemotherapy.
We conducted a comprehensive search of PubMed, Cochrane Library, and Ichushi-Web databases for relevant studies published from January 1990 to December 2020. We included studies comparing multi-day and single-day antiemetic regimens for preventing chemotherapy-induced nausea and vomiting.
No studies directly comparing multi-day versus single-day antiemetic regimens were found. Despite expanding control group criteria beyond "single-day antiemetic therapy" limited high-quality studies and variations in cancer types, chemotherapy regimens, and antiemetic treatments precluded meta-analysis. Among the included studies, some randomized controlled trials (RCTs) focused on complete response and vomiting rates. Two studies comparing two- and three-drug combinations reported higher complete response and no-vomiting rates with the three-drug regimen. Limited RCTs explored "nausea control" and "cost," and assessing "adverse events" proved challenging due to inconsistent reporting.
The research on multi-day antiemetic therapy is limited, necessitating further investigation. Nonetheless, our findings suggest that three-drug combination therapy, including aprepitant, may offer superior antiemetic efficacy compared to two-drug regimens. Multi-day antiemetic therapy is strongly recommended during multi-day intravenous administration of cytotoxic anticancer drugs.
针对多日化疗的标准化多日止吐方案仍未确定。本系统评价评估了多日止吐方案在接受多日静脉化疗患者中的疗效和安全性。
我们全面检索了PubMed、Cochrane图书馆和Ichushi-Web数据库，以查找1990年1月至2020年12月发表的相关研究。我们纳入了比较多日和单日止吐方案预防化疗引起的恶心和呕吐的研究。
未发现直接比较多日与单日止吐方案的研究。尽管将对照组标准扩大到“单日止吐治疗”之外，但高质量研究有限，且癌症类型、化疗方案和止吐治疗的差异妨碍了荟萃分析。在纳入的研究中，一些随机对照试验（RCT）关注完全缓解率和呕吐率。两项比较两药和三药联合方案的研究报告，三药方案的完全缓解率和无呕吐率更高。有限的RCT探讨了“恶心控制”和“成本”，由于报告不一致，评估“不良事件”具有挑战性。
多日止吐治疗的研究有限，需要进一步调查。尽管如此，我们的研究结果表明，与两药方案相比，包括阿瑞匹坦在内的三药联合治疗可能具有更好的止吐效果。在多日静脉给予细胞毒性抗癌药物期间，强烈建议采用多日止吐治疗。
