Therapeutic and Preventive Antiemetic Effect of Aprepitant in Japanese Patients with Thoracic Malignancies Who Truly Need It.
Therapeutic and Preventive Antiemetic Effect of Aprepitant in Japanese Patients with Thoracic Malignancies Who Truly Need It.
复制标题
阿瑞吡坦对日本真正需要的胸部恶性肿瘤患者的治疗和预防止吐作用。
DOI：
10.1007/s00520-014-2430-x
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发表时间：
2015
影响因子：
3.1
通讯作者：
Kubo A.
中科院分区：
文献类型：
--
作者：
Ito S;Tsukiyama I;Ando M;Katakami M;Hamanaka R;Kosaka K;Matsubara A;Nishimura M;Tanaka H;Asai N;Yokoe N;Takahashi A;Baba K;Matsuura K;Yamaguchi E;Kubo A.
神经激肽-1（NK-1）受体拮抗剂被推荐用于高致吐性化疗（HEC）中化疗诱导的恶心和呕吐（CINV），最近在日本已被引入肿瘤学实践。然而，是否所有接受HEC的患者都真正需要NK-1受体拮抗剂仍然未知，并且由于统一使用NK-1受体拮抗剂而增加的医疗成本是一个问题。进行本研究以检查在日本引入时需要阿瑞匹坦的患者的患病率，以及阿瑞匹坦对HEC或中度致吐化疗（MEC）的治疗和预防效果。患者和方法接受HEC或MEC的胸部恶性肿瘤合格患者接受5-羟色胺受体拮抗剂和地塞米松以预防CINV。给予阿瑞匹坦治疗第一疗程发生的CINV，或预防第二疗程发生的CINV。呕吐的频率，恶心的程度，和生活质量方面CINV.ResultsIn总，96例患者参加了评估。分别有57%和88%的接受HEC和MEC治疗的患者未给予阿瑞匹坦。在接受阿瑞匹坦治疗的患者（n= 18）中，发生CINV后治疗性使用阿瑞匹坦（n= 9）使恶心数字评定量表的平均评分从7.44降至5.44（p= 0.10），每天呕吐的平均频率从2.11降至0.11（p= 0.03）。在第二个疗程中预防性使用阿瑞匹坦（n= 18）使无明显恶心的患者比例从6%（第一个疗程）增加到50%（第二个疗程;p= 0.007），无呕吐的患者比例从33%增加到89%（p= 0.002）。阿瑞匹坦的使用也显着提高了生活质量，就CINV在第二course.ConclusionMore超过一半的患者接受HEC和88%的患者接受MEC没有使用阿瑞匹坦。阿瑞匹坦在真正需要的患者中对CINV表现出显著的治疗和预防作用。
PurposeNeurokinin-1 (NK-1) receptor antagonist is recommended for chemotherapy-induced nausea and vomiting (CINV) in highly emetogenic chemotherapy (HEC) and has recently been introduced to oncology practice in Japan. However, whether all patients undergoing HEC truly need NK-1 receptor antagonist remains unknown, and increasing medical costs due to uniform use of NK-1 receptor antagonist are a concern. This study was conducted to examine the prevalence of patients who needed aprepitant at the time of its introduction in Japan, and therapeutic and preventive effects of aprepitant on HEC or moderately emetogenic chemotherapy (MEC).Patients and methodsEligible patients with thoracic malignancies who were to undergo HEC or MEC received 5-hydroxytryptamine receptor antagonists and dexamethasone to prevent CINV. Aprepitant was administered to treat CINV occurring in the first course, or to prevent CINV in the second course. Frequency of vomiting, degree of nausea, and quality of life with respect to CINV were assessed.ResultsIn total, 96 patients were enrolled. Aprepitant was not administered in 57 and 88 % of patients who received HEC and MEC, respectively. In patients treated with aprepitant (n= 18), therapeutic use of aprepitant after occurrence of CINV (n= 9) decreased average scores in numerical rating scale for nausea from 7.44 to 5.44 (p= 0.10), and average frequency of vomiting per day from 2.11 to 0.11 (p= 0.03). Prophylactic use of aprepitant in the second course (n= 18) increased the proportion of patients with no significant nausea from 6 % (first course) to 50 % (second course;p= 0.007), and those with no vomiting from 33 to 89 % (p= 0.002). Aprepitant use also significantly improved quality of life with respect to CINV in the second course.ConclusionMore than half of patients receiving HEC and 88 % of patients receiving MEC did not use aprepitant. Aprepitant showed significant therapeutic and preventive effects on CINV in patients who truly needed it.