Póka R, Hernádi Z, Juhász B, Lampé L
Department of Obstetrics and Gynecology, University Medical School of Debrecen, Hungary.
Int J Gynaecol Obstet. 1993 Jul;42(1):19-24. doi: 10.1016/0020-7292(93)90440-8.
To improve the treatment of cisplatin-induced acute emesis and vomiting, the adjuvant effect of two different doses of metoclopramide and metoclopramide plus droperidol was compared to a defined standard antiemetic regiment.
One-hundred and twenty-one consecutive cisplatin-based chemotherapy treatments for ovarian carcinoma were randomly assigned to receive standard plus no adjuvant (control, n = 24), high-dose metoclopramide (HDM, n = 33), very high dose metoclopramide (VHDM, n = 50) and very high dose metoclopramide plus droperidol (VHDM+DP, n = 14) antiemetic treatment. The number of vomiting episodes up to 4 h after the treatment were recorded and compared in the four different antiemetic groups. The effect of the number of previous chemotherapy cycles, the strength of previous antiemetic treatments, age and stage of disease on the number of vomiting episodes was also assessed.
The mean number of vomiting episodes during the first 4 h after the chemotherapy was 9, 6.4, 6.2 and 2.7 among patients receiving the standard HDM, VHDM and VHDM+DP antiemetic regimens, respectively. Analysis of variance of vomiting episodes confirmed significant differences between the groups (P < 0.001, F = 406.5, df = 120). The number of previous chemotherapy cycles and, to a lesser extent, the stage of disease, the strength of previous antiemetic regimens and the age showed significant correlation with the number of vomiting episodes (r = 0.443, -0.159, -0.14 and -0.009 respectively).
Substantial improvement in the control of cisplating-induced vomiting can be achieved by adding high-dose metoclopramide and droperidol to a basic antiemetic regimen consisting prochlorperazine, dexamethasone and thiethylperazine.
为改善顺铂所致急性呕吐的治疗效果，将两种不同剂量的甲氧氯普胺以及甲氧氯普胺加氟哌利多的辅助作用与一种既定的标准止吐方案进行比较。
对121例连续接受以顺铂为基础的卵巢癌化疗的患者进行随机分组，分别接受标准治疗且无辅助用药（对照组，n = 24）、高剂量甲氧氯普胺（HDM，n = 33）、极高剂量甲氧氯普胺（VHDM，n = 50）以及极高剂量甲氧氯普胺加氟哌利多（VHDM+DP，n = 14）的止吐治疗。记录并比较四个不同止吐组治疗后4小时内的呕吐发作次数。还评估了既往化疗周期数、既往止吐治疗强度、年龄和疾病分期对呕吐发作次数的影响。
接受标准、HDM、VHDM和VHDM+DP止吐方案的患者在化疗后最初4小时内的平均呕吐发作次数分别为9次、6.4次、6.2次和2.7次。呕吐发作次数的方差分析证实各组之间存在显著差异（P < 0.001，F = 406.5，自由度 = 120）。既往化疗周期数，以及在较小程度上疾病分期、既往止吐方案强度和年龄与呕吐发作次数显示出显著相关性（分别为r = 0.443、-0.159、-0.14和-0.009）。
在由丙氯拉嗪、地塞米松和硫乙拉嗪组成的基本止吐方案中添加高剂量甲氧氯普胺和氟哌利多，可显著改善顺铂所致呕吐的控制。
