Jantunen I T, Kataja V V, Muhonen T T
Department of Radiotherapy and Oncology, Central Hospital of Central Finland, Jyväskylä, Finland.
Eur J Cancer. 1997 Jan;33(1):66-74. doi: 10.1016/s0959-8049(96)00276-6.
Ten years after it was demonstrated in the ferret that cisplatin-induced emesis could be blocked by the selective 5-HT3 receptor antagonist MDL 72222, 5-HT3 receptor antagonists have become routine anti-emetic agents for chemotherapy-induced emesis. However, although in association with highly emetogenic, mainly cisplatin-containing regimens, the use of these agents is well justified, the net benefit of 5-HT3 receptor antagonists in association with moderately emetogenic regimens has not been that well clarified. Here, we present an overview of 30 randomised studies comparing 5-HT3 antagonists with the conventional anti-emetics in the prophylaxis of acute vomiting induced by cytotoxic chemotherapy. A meta-analysis showed that 5-HT3 antagonists reduce the risk of acute vomiting in comparison to conventional anti-emetics both with cisplatin treatments (15 trials; odds ratio 0.60; 95% confidence interval 0.51-0.70) and with moderately emetogenic treatments (11 trials; odds ratio 0.47; 95% confidence interval 0.39-0.58). The risk of acute vomiting seems to be further reduced when 5-HT3 antagonists are combined with dexamethasone.
在雪貂实验中证实顺铂诱导的呕吐可被选择性5-HT3受体拮抗剂MDL 72222阻断十年后，5-HT3受体拮抗剂已成为化疗所致呕吐的常规止吐药物。然而，尽管在与高致吐性（主要是含顺铂方案）联合使用时，这些药物的使用是完全合理的，但5-HT3受体拮抗剂与中度致吐方案联合使用的净效益尚未得到很好的阐明。在此，我们概述了30项比较5-HT3拮抗剂与传统止吐药预防细胞毒性化疗引起的急性呕吐的随机研究。一项荟萃分析表明，与传统止吐药相比，5-HT3拮抗剂在顺铂治疗（15项试验；比值比0.60；95%置信区间0.51-0.70）和中度致吐治疗（11项试验；比值比0.47；95%置信区间0.39-0.58）中均降低了急性呕吐的风险。当5-HT3拮抗剂与地塞米松联合使用时，急性呕吐的风险似乎会进一步降低。
