Tsavaris N, Charalambidis G, Pagou M, Karabelis A, Mylonakis N, Bacoyiannis C, Kosmidis P
Second Department of Medical Oncology, Metaxa Cancer Hospital, Piraeus, Greece.
Am J Clin Oncol. 1994 Dec;17(6):516-21. doi: 10.1097/00000421-199412000-00014.
The purpose of our study was to evaluate the effectiveness of alprazolam (APZ) as an adjuvant drug to ondansentron against cisplatin-induced emesis. All patients received CDDP 100 mg/m2, and had previously received chemotherapy. We established two groups of patients randomly: Group A patients received 5-HT3 alone, and Group B received 5-HT3 and APZ. The drugs were administered as follows: 5-HT3 was given at a dose of 1 ampule 8 mg in 100 ml N/S in 10 minutes i.v. infusion before the infusion of CDDP. We continued with 1 tablet 8 mg in the afternoon and 1 before sleeping the first day; for the next two days, patients received 3 tablets 8 mg/day. APZ was given in tablets of 0.25 mg 60 minutes before CDDP infusion and then with the second and third dose of 5-HT3. We did not find significant differences in clinical parameters and factors, especially anxiety, that influenced vomiting between the examined groups. The mean number of vomiting episodes without gastric content (4.76 episodes) and the mean duration of nausea (195 minutes), were greater in Group A than in Group B (1.39 episodes, p < .0001; 91 minutes, p < .049). Differences also were found in the mean number of vomiting episodes with gastric content between the examined groups (A: 1.97; B: 1.09; p < .135). The intense of nausea and vomiting according to WHO classification was greater in Group A (grade 0, p < .004; grade 2, p < .020) than in Group B. Patients of Group B had fewer problems with appetite (p < .027), and more intense sedative effect (grade 0 [p < .001], 1 [0.027], 2 [0.022]) than patients of Group A. In conclusion APZ improved the antiemetic efficacy of ondansentron in cisplatin-induced emesis.
我们研究的目的是评估阿普唑仑（APZ）作为昂丹司琼辅助药物对抗顺铂引起呕吐的有效性。所有患者均接受100mg/m²顺铂治疗，且之前均接受过化疗。我们将患者随机分为两组：A组患者仅接受5-羟色胺3（5-HT3）受体拮抗剂治疗，B组患者接受5-HT3受体拮抗剂和阿普唑仑治疗。药物给药方式如下：在输注顺铂前10分钟，将5-HT3受体拮抗剂8mg以1安瓿的剂量加入100ml生理盐水中静脉输注10分钟。第一天下午继续服用1片8mg，睡前服用1片；接下来的两天，患者每天服用3片8mg。阿普唑仑在顺铂输注前60分钟口服0.25mg片剂，然后与第二剂和第三剂5-HT3受体拮抗剂一起服用。我们没有发现两组在影响呕吐的临床参数和因素，特别是焦虑方面存在显著差异。A组无胃内容物的呕吐发作平均次数（4.76次）和恶心平均持续时间（195分钟）均高于B组（1.39次，p <.0001；91分钟，p <.049）。两组有胃内容物的呕吐发作平均次数也存在差异（A组：1.97次；B组：1.09次；p <.135）。根据世界卫生组织分类，A组恶心和呕吐的严重程度高于B组（0级，p <.004；2级，p <.020）。B组患者食欲问题较少（p <.027），镇静作用比A组患者更强（0级[p <.001]，1级[0.027]，2级[0.022]）。总之，阿普唑仑提高了昂丹司琼对顺铂引起呕吐的止吐疗效。
