Dexamethasone-sparing regimen is an effective and safe alternative in overall antiemetic protection
Dexamethasone-sparing regimen is an effective and safe alternative in overall antiemetic protection
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DOI：
10.1097/md.0000000000017364
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Guo-Qin Jiang
中科院分区：
文献类型：
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作者：
Yan-Lin Gu;Jia-ming Xie;Jie Ren;Hua Cao;Jin-rong Wei;Chao Chen;Le-Ning Shao;Guo-Qin Jiang
Objective: We performed a meta-analyisis to evaluate the efficacy of maintenance dexamethasone against acute or delayed chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetic risk chemotherapy regimen..Methods: PubMed, Embase, and Cochrane Library were searched for eligible studies. Data comparing maintenance dexamethasone with single-dose dexamethasone during the acute, delayed, and overall phase of CINV were extracted. Overall risk ratio (RR) was used to estimate the efficacy and adverse effects..Results: Nine studies were included. In delayed phase, maintenance dexamethasone has similar efficacy to single-dose dexamethasone for no emetic episodes (RR, 1.06; 95% confidence interval [CI], 1.00–1.14), complete response (RR, 1.04; 95% CI,0.98–1.11), complete control (RR, 1.07; 95% CI, 0.98–1.16), and total control (RR, 1.06; 95% CI, 0.91–1.23). In overall phase,maintenance dexamethasone has similar efficacy to single-dose dexamethasone for no emetic episodes (RR, 1.02; 95% CI, 0.94–1.11), complete response (RR, 1.02; 95% CI, 0.95 -1.09), complete control (RR, 1.03; 95% CI, 0.94–1.13), total control (RR, 1.05;95% CI, 0.90–1.23), and no rescue medication (RR, 1.07; 95% CI, 0.97–1.19). Maintenance dexamethasone was only superior to single-dose dexamethasone for no rescue medication during delayed phase (RR, 1.10; 95% CI, 1.01–1.21, P=.034). The incidence of hiccup was observed higher in maintenance dexamethasone group (RR=3.16, 95% CI, 1.12–8.92)..Conclusion: The single-dose dexamethasone regimen offers high and similar overall control of symptoms as the maintenance dexamethasone regimen in this population. Multiple-day dexamethasone was suitable for patients who used rescue medication during the delayed phase..Abbreviations: AC = anthracycline/cyclophosphamide, CC = complete control, CINV = chemotherapy-induced nausea and vomiting, CR = complete response, HEC = highly emetogenic chemotherapy, MEC = moderately emetogenic chemotherapy, MeSH terms = medical subject heading terms, NCCN = National Comprehensive Cancer Network, OR = odds ratio, RR = risk ratio, TC = total control.
