Chemotherapy-induced nausea and vomiting and antiemetic prophylaxis with palonosetron versus other 5-HT3 receptor antagonists in patients with cancer treated with low emetogenic chemotherapy in a hospital outpatient setting in the United States
Chemotherapy-induced nausea and vomiting and antiemetic prophylaxis with palonosetron versus other 5-HT3 receptor antagonists in patients with cancer treated with low emetogenic chemotherapy in a hospital outpatient setting in the United States
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DOI：
10.1185/03007995.2011.596201
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发表时间：
2011-08-01
影响因子：
2.3
通讯作者：
Cox, David
中科院分区：
文献类型：
--
作者：
Schwartzberg, Lee;Morrow, Gary;Cox, David
背景：在接受单天和多天低致吐性化疗（LEC）治疗的患者中，总体（急性和延迟）化疗引起的恶心和呕吐（CINV）事件的发生率尚未得到很好的确定。我们研究了一组接受LEC和palonosetron止吐预防（1组）与其他5-HT3受体拮抗剂（5-HT3- ras）（2组）的患者，以确定在医院门诊环境中CINV的总体发生率和延迟CINV （CT周期2-7天）的患者比例。方法：在2007年4月1日至2009年3月31日期间，从Premier Perspective数据库中筛选年龄为bb0 = 18岁的首次进行一日和多日LEC的癌症诊断患者。描述性地评估CINV事件（ICD-9-CM编码恶心、呕吐或容量减少或CINV相关抢救药物）。建立广义线性多元回归模型，估计1组和2组患者在随访期间（8个化疗[CT]周期或6个月中的第一个周期）的总体CINV发生率。结果：在随访期间，总共10137例CINV事件（单天和多日LEC）中，8783例事件（86.6%）发生在单天LEC治疗的患者中。在第一个周期的3184个LEC治疗事件中，2996个（94.1%）事件延迟。每位患者延迟事件的平均次数在整个8个周期中保持一致（3.1例[第1周期]vs. 2.9例[第8周期]；P = 0.842]）。在2439例使用5-HT3-RA进行止吐预防的患者中，10.1% （n = 247）的患者开始使用帕洛诺司琼。回归分析显示，组1患者（与组2相比）每个CT周期的CINV事件发生率降低15.2%；P = 0.0403。研究的局限性包括可能缺乏通用性，缺乏某些混杂因素（包括饮酒和既往晕动病史）的数据，可能低估不受控制的CINV发病率，以及无法得出有关因果关系的结论。结论：在这项回顾性分析中，延迟CINV占癌症诊断患者的总CINV的主要比例。此外，帕洛诺司琼预防与a
Background:The incidence of overall (acute and delayed) chemotherapy-induced nausea and vomiting (CINV) events among patients treated with single-and multi-day low emetogenic chemotherapy (LEC) is not well established. We studied a cohort of patients receiving LEC and antiemetic prophylaxis with palonosetron (Group 1) versus other 5-HT3 receptor antagonists (5-HT3-RAs) (Group 2), to determine the overall rate of CINV and the proportion of patients experiencing delayed CINV (days 2-7 of a CT cycle) in a hospital outpatient setting.Methods:Patients aged >= 18 years with cancer diagnosis initiating single-day and multi-day LEC for the first time between 4/1/2007 and 3/31/2009 were identified from the Premier Perspective database. CINV events (ICD-9-CM codes for nausea, vomiting, or volume depletion or CINV-related rescue medications) were assessed descriptively. A generalized linear multivariate regression model was developed, estimating the overall CINV event rate among Group 1 and 2 patients in the follow-up period (first of eight chemotherapy [CT] cycles or 6 months).Results:In the follow-up period, out of a total of 10,137 overall CINV events (single-day and multi-day LEC), 8783 events (86.6%) were identified in single-day LEC treated patients. Within single-day LEC treated events, in the first cycle, of 3184 events, 2996 (94.1%) events were delayed. Average number of delayed events per patient remained consistent throughout the eight cycles (3.1 [1st cycle] vs. 2.9 [8th cycle]; P = 0.842]). Among 2439 patients on antiemetic prophylaxis with a 5-HT3-RA, 10.1% (n = 247) initiated palonosetron. Regression analysis indicated that Group 1 patients (versus Group 2) had a 15.2% reduction in CINV event rate per CT cycle; P = 0.0403. Study limitations include potential lack of generalizability, absence of data on certain confounders including alcohol consumption and prior history of motion sickness, potential underestimation of incidence of uncontrolled CINV, and inability to draw conclusions pertaining to cause and effect relationship.Conclusion:In this retrospective analysis, delayed CINV comprised a major proportion of overall CINV among cancer diagnosed patients on single-day LEC. Additionally, palonosetron prophylaxis was associated with a