The anti-emetic efficacy of tropisetron plus dexamethasone in patients treated with high-dose chemotherapy and stem cell transplantation
The anti-emetic efficacy of tropisetron plus dexamethasone in patients treated with high-dose chemotherapy and stem cell transplantation
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DOI：
10.1007/s005200050231
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发表时间：
1999-03-01
影响因子：
3.1
通讯作者：
Efremidis, A
中科院分区：
文献类型：
--
作者：
Barbounis, V;Koumakis, G;Efremidis, A
接受大剂量化疗和干细胞移植的患者经历的最令人痛苦的症状是恶心和呕吐。高剂量调理方案中使用的化疗方案具有高度致吐性。 5HT(3)受体拮抗剂对于预防和消除化疗药物引起的恶心、呕吐非常有效。其中之一托烷司琼是一种选择性血清素 5HT(3) 受体拮抗剂，已被证明具有抗呕吐功效。地塞米松也被认为是对抗恶心和呕吐的有效药物。将地塞米松添加到 5HT(3) 受体拮抗剂中具有协同作用，正如许多高致吐药物试验所表明的那样。本试验的目的是研究托烷司琼和地塞米松联合治疗干细胞移植前接受大疗法的患者控制恶心和呕吐的功效和安全性。我们研究了 31 名患者。所有这些都可以评估反应和毒性。大多数患者获得了针对急性呕吐的完全或主要保护（71-83%），67-84% 的患者没有或有轻微恶心。该组合的耐受性良好，只有少数患者报告有副作用。其中最常见的是头痛（三名患者）和便秘。没有患者因毒性而退出研究。从我们的数据中可以明显看出，每天服用 5 mg 托烷司琼联合 20 mg 地塞米松 8 天可以预防急性呕吐，否则接受高剂量化疗的患者在干细胞移植计划中会经历急性呕吐。
Among the most distressing symptoms experienced by patients who have undergone high-dose chemotherapy and stem cell transplantation are nausea and vomiting. The chemotherapy regimens used in high-dose conditioning protocols are highly emetogenic. The 5HT(3) receptor antagonists are very effective in the prevention and abolition of nausea and vomiting resulting from chemotherapeutic drugs. One of them, tropisetron, is a selective antagonist of serotonin 5HT(3) receptors with proven efficacy against emesis. Dexamethasone is also known as an effective agent against nausea and vomiting. The addition of dexamethasone to a 5HT(3) receptor antagonist is synergistic, as has been shown in many trials with highly emetogenic drugs. The aim of the present trial was to study the efficacy and safety profile of the combination of tropisetron and dexamethasone in controlling nausea and vomiting in patients receiving megatherapy prior to stem cell transplantation. We studied 31 patients. All of them were evaluable for response and toxicity. The majority of patients achieved complete or major protection against acute vomiting (71-83%), and 67-84% of the patients had no or mild nausea. The combination was tolerated well, and only a minority of patients reported side effects. Among them the most common were headache (in three patients) and constipation. No patient withdrew from the study because of toxicity. It has become evident from our data that the administration of 5 mg tropisetron daily in combination with 20 mg dexamethasone for 8 days can prevent the acute emesis otherwise experienced by patients receiving high-dose chemotherapy as conditioning in stem cell transplantation programmes.