Holdsworth M T, Raisch D W, Duncan M H, Chavez C M, Leasure M M
College of Pharmacy, University of New Mexico, Albuquerque 87131.
Ann Pharmacother. 1995 Jan;29(1):16-21. doi: 10.1177/106002809502900103.
To measure the severity of nausea and vomiting in pediatric patients receiving intravenous or intrathecal chemotherapy for acute lymphoblastic leukemia and to evaluate the effectiveness of 2 intravenous doses of ondansetron for this condition.
Patients were surveyed during repeated treatments of maintenance chemotherapy, given with or without ondansetron, using a repeated measures pretest/posttest design.
Outpatient pediatric oncology clinic.
Sixteen pediatric patients (aged 2-15 years, mean 6.2) with acute lymphoblastic leukemia.
Surveys to assess nausea and vomiting and the extent of interference with daily activities were administered following emetogenic chemotherapy with or without ondansetron.
A total of 255 surveys following emetogenic chemotherapy with daunorubicin, cyclophosphamide, carmustine, and etoposide and cytarabine combined, as well as intrathecal therapy with methotrexate, hydrocortisone, and cytarabine, were analyzed. Analysis was performed on surveys of 149 courses without antiemetic therapy and 106 courses after 2 doses of ondansetron 0.15 mg/kg iv. The most emetogenic chemotherapy treatment was the etoposide/cytarabine combination (p < 0.05). Ondansetron completely protected patients (defined as no nausea or no vomiting) during most (> 50%) of the chemotherapy treatments, except for those in which cyclophosphamide was used. Ondansetron provided greater control of nausea and vomiting, a higher percentage of complete protection, and decreased the daily activity interference rating for carmustine and etoposide/cytarabine compared with courses of chemotherapy without antiemetics (p < 0.05). Two intravenous doses of ondansetron also provided durable antiemetic efficacy over time for the most emetogenic chemotherapy treatment (etoposide/cytarabine).
Etoposide/cytarabine proved to be the most emetogenic of the chemotherapy treatments studied. A reduced-dose regimen of intravenous ondansetron was shown to be an effective antiemetic for the outpatient treatments with etoposide/cytarabine and carmustine, but not with cyclophosphamide.
测量接受急性淋巴细胞白血病静脉或鞘内化疗的儿科患者恶心和呕吐的严重程度，并评估静脉注射两剂昂丹司琼对此情况的有效性。
采用重复测量的前测/后测设计，在接受或不接受昂丹司琼的维持化疗重复治疗期间对患者进行调查。
儿科门诊肿瘤诊所。
16名患有急性淋巴细胞白血病的儿科患者（年龄2 - 15岁，平均6.2岁）。
在接受或不接受昂丹司琼的致吐性化疗后，进行评估恶心和呕吐以及对日常活动干扰程度的调查。
共分析了255份在使用柔红霉素、环磷酰胺、卡莫司汀、依托泊苷和阿糖胞苷联合进行致吐性化疗以及鞘内注射甲氨蝶呤、氢化可的松和阿糖胞苷后进行的调查。对149个未进行止吐治疗疗程和106个静脉注射两剂0.15mg/kg昂丹司琼后的疗程的调查进行了分析。最具致吐性的化疗治疗是依托泊苷/阿糖胞苷联合治疗（p < 0.05）。除使用环磷酰胺的治疗外，在大多数（> 50%）化疗治疗期间，昂丹司琼完全保护患者（定义为无恶心或无呕吐）。与未使用止吐药的化疗疗程相比，昂丹司琼能更好地控制恶心和呕吐，提供更高百分比的完全保护，并降低了卡莫司汀和依托泊苷/阿糖胞苷对日常活动的干扰评分（p < 0.05）。对于最具致吐性的化疗治疗（依托泊苷/阿糖胞苷），静脉注射两剂昂丹司琼随着时间推移也提供了持久的止吐疗效。
在研究的化疗治疗中，依托泊苷/阿糖胞苷被证明是最具致吐性的。静脉注射昂丹司琼的低剂量方案被证明是门诊治疗依托泊苷/阿糖胞苷和卡莫司汀时有效的止吐药，但对环磷酰胺无效。
