阿瑞匹坦联合地塞米松磷酸钠及盐酸帕洛诺司琼预防骨肉瘤化疗后恶心呕吐的效果

Effect of aripitan combined with dexamethasone sodium phosphate and panolosetron in prevention of nausea and vomiting after chemotherapy for osteosarcoma

  • 摘要: 目的 观察阿瑞匹坦联合地塞米松磷酸钠及盐酸帕洛诺司琼在预防骨肉瘤患者应用顺铂、盐酸表柔比星联合异环磷酰胺化疗后恶心呕吐的疗效及其安全性。 方法 将接受骨肉瘤手术治疗且以顺铂、盐酸表柔比星联合异环磷酰胺为方案进行化疗的197例患者随机分为2组,阿瑞匹坦组(n=99)予以三联止吐方案,对照组(n=98)予以二联止吐方案。分别观察2组患者术前化疗、术后前3次化疗和术后后3次化疗0~24 h及>24~144 h内恶心呕吐的完全缓解(CR)率及不良反应的发生情况。 结果 术前化疗后第0~24小时,阿瑞匹坦组和对照组的完全缓解率分别为75.76%和70.41%, 差异无统计学意义(P>0.05); >24~144 h后,阿瑞匹坦组和对照组的完全缓解率分别为68.69%和54.08%, 差异有统计学意义(P<0.05)。术后前3次化疗后0~24 h, 阿瑞匹坦组和对照组的完全缓解率分别为67.68%和61.22%, 差异无统计学意义(P>0.05); >24~144 h, 阿瑞匹坦组和对照组的完全缓解率分别为59.60%和44.90%, 差异有统计学意义(P<0.05)。术后后3次化疗第0~24小时,阿瑞匹坦组和对照组的完全缓解率分别为52.53%和50.00%, 差异无统计学意义(P>0.05); >24~144 h, 阿瑞匹坦组和对照组的完全缓解率分别为46.46%和32.65%(P<0.05)。术前化疗、术后前3次化疗、术后后3次化疗时, 2组不良反应发生率均无显著差异(P>0.05), 但阿瑞匹坦组不良反应发生率略高于对照组。 结论 阿瑞匹坦联合盐酸帕洛诺司琼及地塞米松磷酸钠预防顺铂、盐酸表柔比星联合异环磷酰胺化疗方案对化疗0~24 h内恶心呕吐的疗效不明显,但对>24~144 h内的恶心呕吐具有显著疗效,且安全性较好,但疗效随着化疗的多次进行逐渐减弱。

     

    Abstract: Objective To observe the efficacy and safety of aripitan combined with dexamethasone sodium phosphate and panolosetron in preventing nausea and vomiting of patients with osteosarcoma after chemotherapy with cisplatin, epirubicin hydrochloride and ifosfamide. Methods A total of osteosarcoma patients who were given cisplatin plus epirubicin hydrochloride plus ifosfamide for chemotherapy were randomly divided into aripitan group(n=99)with triple antiemetic program and control group(n=98)with two antiemetic drug in combination. The complete response(CR)rates of nausea and vomiting and occurrence of adverse reactions at 0~24 h and >24~144 h were observed before chemotherapy, the first three times and latter three times of postoperative chemotherapies in the two groups were also observed. Results The complete remission rates in the aripitan group and control group were 75.76% and 70.41%, respectively at 0~24 h after chemotherapy, and no significant difference were observed(P>0.05), and 68.69% and 54.08%, respectively at >24~144 h, which showed significant difference(P<0.05). The complete remission rates in the aripitan group and control group were 67.68% and 61.22%, respectively at 0~24 h after the first three chemotherapies, but no significant difference were observed(P>0.05), and 59.60% and 44.90% - at >24~144 h, which showed significant difference(P<0.05). The complete remission rates in the aripitan group and control group were 52.53% and 50.00%, respectively at 0~24 h after latter three times of chemotherapies, there were no significant differences between the two groups(P>0.05), and were 46.46% and 32.65%, respectively at >24~144 h in the two groups, which showed significant difference(P<0.05). There were no differences before chemotherapy, after the first three times of chemotherapies and latter three times of chemotherapies in the incidence of adverse reactions between the two groups(P>0.05), but the incidence of adverse reactions in the aripitan group was slightly higher than that in the control group. Conclusion Aripitan combined with palonosetron hydrochloride and dexamethasone sodium phosphate has no significant effect on nausea and vomiting within 0~24 h after chemotherapy, and has a significant effect within >24~144 h. Besides, it has better efficacy, but the therapeutic effect gradually decreases with the repeated chemotherapies.

     

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