COURSE, PATTERNS, AND RISK-FACTORS FOR CHEMOTHERAPY-INDUCED EMESIS IN CISPLATIN-PRETREATED PATIENTS - A STUDY WITH ONDANSETRON
COURSE, PATTERNS, AND RISK-FACTORS FOR CHEMOTHERAPY-INDUCED EMESIS IN CISPLATIN-PRETREATED PATIENTS - A STUDY WITH ONDANSETRON
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DOI：
10.1016/s0959-8049(05)80075-9
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发表时间：
1992-02-01
影响因子：
8.4
通讯作者：
PFLEIDERER, A
中科院分区：
文献类型：
--
作者：
DUBOIS, A;MEERPOHL, HG;PFLEIDERER, A
呕吐和恶心是癌症化疗最令人痛苦的副作用。 采用标准止吐方案（例如，基于甲氧氯普胺的组合），在50-70%的顺铂治疗患者中实现了充分的止吐控制。 昂丹司琼是一种选择性5-HT_3受体拮抗剂，对顺铂引起的呕吐有疗效。 在本研究中，我们评估了昂丹司琼在顺铂预治疗的患者中的安全性和有效性，这些患者尽管接受了止吐预防，但仍患有严重呕吐。 43.5%的患者在治疗当天达到完全止吐控制，27.2%的患者在最差日分析中达到止吐控制。 25%的患者出现严重的顺铂引起的呕吐（每24 h呕吐发作> 5次）。 我们试图通过多因素分析来排除顺铂引起呕吐的危险因素。 性别、顺铂剂量和顺铂+蒽环类药物联合治疗似乎是第1天和最差天数呕吐的独立风险因素。 当已经获得足够的止吐保护以防止急性呕吐时，迟发性呕吐较少发生。 女性、顺铂剂量和复发性疾病似乎影响迟发性呕吐的发生概率。
Vomiting and nausea are the most distressing side-effects of cancer chemotherapy. With standard antiemetic regimens (e.g. metoclopramide based combinations) sufficient antiemetic control is achieved in 50-70% of cisplatin treated patients. Ondansetron, a selective 5-HT3-receptor antagonist has shown efficacy in cisplatin-induced emesis. In the present study, we evaluated the safety and efficacy of ondansetron in cisplatin pretreated patients who had suffered from severe emesis in spite of antiemetic prophylaxis. Complete antiemetic control was reached in 43.5% on the day of treatment and in 27.2% of the patients regarding a worst day analysis. 25% of the patients suffered from severe cisplatin-induced emesis (> 5 emetic episodes per 24 h). We try to characterise risk-factors for cisplatin-induced emesis by performing a multivariate analysis. Sex, cisplatin dose, and combination therapy with cisplatin plus anthracyclines seem to be independent risk-factors for vomiting on day 1 and on worst day. Delayed emesis occurred less often when sufficient antiemetic protection from acute vomiting had been obtained. Female sex, cisplatin dose and recurrent disease seem to influence the probability for occurrence of delayed vomiting.