盐酸格拉司琼联合地塞米松预防顺铂所致呕吐的临床疗效

目的：观察盐酸格拉司琼联合地塞米松的止吐效果，方法：对57例接受顺铂化疗的患者，随机分为两组，即单剂盐酸格拉司琼和盐酸格拉司琼加地塞米松组，采用交叉对比的方法，比较单剂盐酸格拉司琼和盐酸格拉司琼加地塞米松联用的疗效，结果：单剂盐酸格拉司琼对呕吐的完全控制率为68．5％，盐酸格拉民事琼加地塞米松联用则为87．7％，两组比较差异显著，P＜0．01，结论：盐酸格拉司琼与地塞米松联用可显著改善顺铂引起的急性呕吐。     

盐酸格拉司琼胶囊预防顺铂化疗所致恶心呕吐的疗效观察

采用自身对照方法 ,对 68例恶性肿瘤患者以顺铂为主联合化疗 ,第 1、第 2周期分别使用胃复安、盐酸格拉司琼胶囊 (欧普定 ) ,比较两组控制恶心呕吐反应的效果。两药止吐有效率分别为 47 0 6%及 83 82 % ,其止吐效果差异有极显著性 (P <0 0 1) ,两药毒副反应均较轻。欧普定为一高效、经济、安全的化疗止吐药     

单剂欧必亭加地塞米松预防大剂量顺铂所致的恶心呕吐

目的　研究单剂欧必亭加地塞米松预防大剂量顺铂化疗所致恶心呕吐的疗效。方法　将 93例接受大剂量顺铂化疗的患者随机分为欧必亭组和枢复宁组 ,分别于第 1天用顺铂前 30min静滴地塞米松 1 0mg ,静注欧必亭 5mg或枢复宁 8mg ,观察两组急性和迟发性恶心呕吐的控制率。 结果　欧必亭组预防急性恶心、呕吐的有效率分别为 97.9%和 95 .8% ,CR率均为 91 .6 % ;预防迟发性恶心、呕吐的有效率均在 80 %以上 ,但CR率偏低 ,有超过一半的患者其迟发性恶心未完全控制。与枢复宁组比较 ,除预防急性恶心的CR率欧必亭组优于枢复宁组外 ,其余指标两组均无显著性差异。结论　单剂欧必亭加地塞米松能有效预防大剂量顺铂化疗所致的急性恶心、呕吐 ,但迟发性恶心、呕吐的完全控制率偏低。     

枢丹预防顺铂所致恶心呕吐的临床观察

枢丹（盐酸恩丹西酮,宁波市天衡制药厂生产）是选择性阻滞５－ＨＴ３受体的高效止吐剂。自１９９７年１月到１９９８年６月对预防顺铂为主化疗所致的恶心呕吐,应用枢丹的疗效、合适的剂量和毒副作用进行了观察。１　材料与方法１１　病例选择１２８例均为住院患者,经病理或细胞学确诊为恶性肿瘤,化疗前各项生化指标正常,可接受化疗,预计生存期大于３个月。Ｋａｒｎｏｆｓｋｙ评分在６０分以上,无胃肠道梗阻或中枢神经系统病变所致的呕吐以及２４小时内无恶心呕吐者入组。１２　一般资料１２８例中,男性８６例,女性４２例;年龄…     

格拉司琼单药与联合用药预防含顺铂方案化疗所致呕吐的随机对照研究

目的:探讨格拉司琼单药与联合多药预防含顺铂方案化疗所致恶心呕吐的疗效和不良反应。方法:采用随机分组、交叉设计、自身对照的研究方法。联合用药组给予格拉司琼+地塞米松+胃复安+维生素B6,单药组仅给格拉司琼。对比第一、二周期化疗后两组急性和延迟性呕吐的完全缓解率、进食状况和不良反应。结果:共入组100例患者,其中1例自动退出,1例因顽固性呃逆退出,98例可评价疗效。联合组和单药组对急性呕吐的完全缓解率分别为73.5%(72/98)和61.2%(60/98)(P=0.009);对延迟性呕吐的完全缓解率分别为49.0％(48/98)和40.8％(40/98)(P=0.015);食欲下降的发生率分别为20.4％(20/98)和45.9％(45/98)(P=0.001)。两组头痛、便秘、胃部不适以及呃逆的发生率差别无统计学意义(均P>0.05),但联合用药组的兴奋失眠患者较单药组多(10例vs 1例)(P=0.005)。结论:格拉司琼联合地塞米松、胃复安、维生素B6对缓解顺铂等强致吐方案化疗的药物性呕吐效果更优,并能改善食欲,是一个安全、有效、经济的一线治疗方案。     

枢星联合方案预防顺铂所致恶心呕吐的疗效观察

目的　观察比较枢星联合方案 (枢星联合地塞米松及胃复安 )和枢丹联合方案 (枢丹联合地塞米松及胃复安 )预防顺铂方案联合化疗引起恶心呕吐的临床疗效。方法　将 93例接受以顺铂为主联合化疗患者随机分成 2组 ,枢星组 5 3例接受 70周期化疗 ,枢丹组 40例接受 5 7周期化疗 ,观察 1～ 5天 ,并对恶心、呕吐控制率进行比较。结果　枢星组对急性恶心呕吐控制率分别为 90 %及94.3 % ,均较枢丹组 ( 77.2 %及 80 .7% )明显提高 (P <0 .0 5 ) ,对延缓性呕吐控制率亦优于枢丹组 (P <0 .0 5 )。结论　枢星联合方案可较好地预防顺铂所致急性恶心、呕吐 ,对延缓性呕吐也有一定疗效。     

欧普定胶囊联合地塞米松预防顺铂所致消化道反应

顺铂是目前最常用的化疗药物之一 ,但严重的消化道反应往往限制了顺铂的临床应用。 5 羟色胺受体阻滞剂多为注射制剂 ,如盐酸格拉司琼 (康泉 )、盐酸恩丹西酮等 ,止吐效果均较好。欧普定为盐酸格拉司琼的口服制剂 ,我院从 2 0 0 1年 9月至 2 0 0 2年6月 ,用欧普定联合地塞米松止吐 ,与康泉联合地塞米松相比 ,取得了同样好的疗效 ,报告如下 :1　材料与方法1.1　一般资料　选择肺癌患者 6 2例中 ,男 4 0例 ,女 2 2例 ,年龄最大 76岁 ,最小 32岁 ,平均 4 9岁 ;肺癌术后辅助化疗 18例 ,Ⅲ～Ⅳ期肺癌 4 4例 ,均经病理或细胞学确诊 ;鳞癌 2 8例 ,…     

枢星片预防顺铂所致呕吐临床观察

枢星片是国产的盐酸格拉司琼片（Ｇｒａｎｉｓｅｔｒｏｎ）,为５羟色胺３（５ＨＴ３）的拮抗剂,可作为中度及高度致吐性化疗的抗吐预防剂,由于口服给药方便、剂量小、疗效高等特点,１９９７年８月至９月我们应用枢星片预防顺铂所致呕吐并与枢丹片（Ｏｎｄａｎｓｅｔｒｏｎ,恩丹西酮）对照,临床观察患者３０例,取得满意疗效,现报告如下。１材料与方法１．１病例选择入选病例标准年龄１８～７５岁,体重５０～８０ｋｇ。即将接受以顺铂为主联合化疗的恶性肿瘤患者。化疗前常规检查肝、肾功能及血象正常者。受试前２４小时内未用过其它…     

格拉司琼治疗53例顺铂所致呕吐临床观察

[目的]观察格拉司琼对顺铂所致恶心、呕吐的临床疗效.[方法]53例接受含顺铂联合化疗的恶性肿瘤患者进行2个疗程的自身对照,随机分格拉司琼与胃复安组,比较治疗效果.[结果]格拉司琼组对恶心、呕吐的完全控制率和有效控制率明显优于胃复安组(P＜0.05).两组间不良反应发生率无明显差异.[结论]格拉司琼可作为预防化疗引起的恶心、呕吐的优选药物.     

Comparison of Granisetron,Ondansetron and Tropisetron for Control of Vomiting and Nausea Induced by Cisplatin

Abstract

Severe nausea and vomiting are common and one of the most feared side effects of cisplatin-based chemotherapy. A total of 106 patients were randomized to receive a single dose of 8 mg ondansetron or 3 mg granisetron or 5 mg tropisetron intravenously as prevention of cisplatin-induced acute nausea and vomiting. Antiemetic therapy was done within 30 minutes before initiating chemotherapy. A questionnaire evaluating nausea, vomiting and retches was administered to patients and the responses were categorized as complete, partial or failure. The response determination was repeated in the first 24 hours, and within 24-72 hours following cisplatin administration.

The complete response rates for ondansetron, granisetron and tropisetron in the first 24 hours were 51.4%, 65.7% and 61.1% respectively. All three agents were highly effective against cisplatin-induced acute and late vomiting and the results were statistically significant. This study demonstrated no significant difference in effectiveness of these three antiemetics. 5-HT3 (5-hydrox-ytryptamine 3) receptor antagonists have similar efficacy in the prevention of nausea and vomiting due to cisplatin. Thus, we recommend that drug choice be based on cost-benefit and patient tolerance.     

去甲长春花碱联合顺铂治疗食管癌52例

目的 :观察去甲长春花碱 (NVB)联合顺铂 (DDP)治疗晚期食管癌的疗效和毒副反应。方法 :随机将 5 2例晚期食管癌患者分为两组。NVB组 :NVB 2 5mg m2 ,静脉推注 ,d1、d5;DDP 30mg m2 ,静脉滴入 ,d2 ～d4。对照组 :醛氢叶酸 (CF) 0 1,静脉滴入 ,d1～d5;5 FU 0 5mg m2 ,静脉滴入 ,d1～d5;DDP 30mg m2 ,静脉滴入 ,d2 ～d4。 2个方案均每 4周重复 ,每例化疗 2个周期。结果 :NVB组总有效率 5 3 3% ,对照组 4 2 3% ,P >0 0 5 ;主要毒副反应为骨髓抑制 ,NVB组白细胞减少发生率为 88 5 % ,对照组为6 5 4 % ,P >0 0 5 ,NVB组成本疗效比大于对照组。结论 :NP方案适合用于复治患者     

盐酸格雷西龙注射液防治肿瘤化疗所致消化道反应的临床观察

盐酸格雷西龙是南京军事研究所研制的第四类新药。本文采用随机分组、自身对照、交叉设计的方法，对37例恶性肿瘤化疗病人进行预防呕吐的临床观察，比较盐酸格雷西龙与进口康泉及国产灭吐灵止吐疗效反应。联合化疗方案为含有顺铂（80mg／m2）或阿霉素（40mg／m2），盐酸格雷西龙或康泉3mg加生理盐水30～50ml稀释，化疗前5分钟静脉推注，第1、3天；灭吐灵20mg，化疗当日肌注，每日2次。每一病人用同一方案化疗2周期。结果表明盐酸格雷西龙注射液的止吐有效率（86．5％）与康泉止吐率（80％）相似，明显好于灭吐灵对照组（有效率41．2％）。其毒副作用与康泉相似，主要为头痛头晕、便秘及腹部不适。头痛头晕发生率为5．4％，便秘及腹部不适为8．1％，无灭吐灵的锥体外系反应。作者认为盐酸格雷西龙是一个安全、有效、经济的预防化疗引起的消化道反应的国产止吐药物。     

Genetic Polymorphisms in the Three Malaysian Races Effect Granisetron Clinical Antiemetic Actions in Breast Cancer Patients Receiving Chemotherapy

Introduction: Nausea and vomiting are recognized as two separate and distinct conditions with a widespectrum of etiologies either directly associated with cancer itself or its treatment. According to the new ranking ofchemotherapy side effects, nausea is the number one or the most disturbing side effects while vomiting is the thirdand sometimes the fifth. The introduction of 5-HT3-recptor antagonists in the early of 1990s has revolutionizedthe treatment of nausea and vomiting, these agents remaining the mainstay of antiemetic therapy today. Ethnicvariation (due to genetic polymorphisms) may lead to diversity in antiemetic treatment pharmacokinetic andpharmacodynamic properties, in terms of distribution, elimination, disposition and clinical effects. The aim ofthe present study was to clarify genetic polymorphism effects in the three main races in Malaysia i.e., Malay,Chinese and Indian, on the clinical antiemetic effects of granisetron. Methods: In this longitudinal prospectiveobservational study, 158 breast cancer patients treated with chemotherapy were monitored for nausea andvomiting in the first 24 hours after chemotherapy administration. The patients were then followed up again after3 to 5 days of chemotherapy. Results: Genetic polymorphisms in the three races in Malaysia have significanteffect on granisetron clinical antiemetic action because each is characterized by variant CYP3A4 enzymaticaction. Conclusion: According to the result, different type of 5-HT3 receptor antagonists, such as tropisetronand dolasetron which are predominantly metabolized by CYP2D6, should be used especially for Chinese breastcancer patients.     

甲地孕酮联合格拉司琼预防化疗所致消化道反应的疗效观察

目的观察甲地孕酮联合格拉司琼预防化疗所致消化道反应的疗效及毒副反应。方法将76例接受含顺铂、阿霉素及环磷酰胺联合化疗的恶性肿瘤患者随机分为治疗组和对照组。治疗组止吐方案:甲地孕酮+格拉司琼+甲氧氯普胺;对照组止吐方案:格拉司琼+甲氧氯普胺,2周期后评价疗效。结果Ⅱ度以上急性恶心、呕吐及迟发性恶心呕吐发生率,治疗组分别为5.3%、9.2%及6.6%;对照组分别为23.7%、28.9%及21.1%,2组比较差异均有统计学意义(P均<0.05)。治疗后治疗组生活质量改善明显优于对照组(P<0.05)。2组毒副反应相近,均较轻微,可耐受。结论甲地孕酮联合格拉司琼预防化疗所致恶心呕吐较单用格拉司琼具有更好的预防效果,并可明显改善患者的生活质量。     

吉西他滨联合顺铂治疗高龄非小细胞肺癌的疗效观察

目的 观察吉西他滨联合顺铂治疗高龄非小细胞肺癌的临床疗效.方法 选择病理学证实的高龄非小细胞肺癌60例,随机分为观察组（30例）和对照组（30例）.观察组:吉西他滨800～1 250 mg/m2,静滴,d1,8;顺铂80 mg/m2,静滴,d3,4,5,21 d为1个周期.对照组:顺铂80 mg/m2,静滴,d3,4,...     

A Randomized Cross-over Study of High-dose Metoclopramide plus Dexamethasone versus Granisetron plus Dexamethasone in Patients Receiving Chemotherapy with High-dose Cisplatin

We carried out a randomized, single-blind, cross-over trial to compare the antiemetic effect, for both acute and delayed emesis, of granisetron plus dexamethasone (GRN+Dx) with that of high-dose metoclopramide plus dexamethasone (HDMP + Dx). Fifty-four patients with primary or metastatic lung cancer, given single-dose cisplatin (> 80 mg/m²) chemotherapy more than twice, were enrolled in this study. They were treated with both HDMP+Dx and GRN+Dx in two consecutive chemotherapy courses. On day 1, patients experienced a mean of 2.5 (SD=4.3) and 0,1 (SD = 0.4) episodes of vomiting in the HDMP+Dx and the GRN + Dx groups, respectively ( P =0.0008). Complete response rate on day 1 was 45 and 90% in the HDMP+Dx and the GRN+Dx groups, respectively ( P = 0.0001). Patients treated with GRN+Dx had a tendency to suffer more episodes of vomiting than the HDMP+Dx group on days 2–5, but it was not statistically significant. Twenty-four patients (57%) preferred the GRN+Dx treatment and 14 patients (33%), HDMP + Dx. In the HDMP + Dx group, nine patients (21%) had an extrapyramidal reaction, and 5 patients (12%) had constipation that lasted for at least two days. In contrast, no patients had extrapyramidal reactions, and IS patients (43%) had constipation in the GRN+Dx group ( P < 0.01). GRN+Dx was more effective than HDMP+Dx only in preventing the acute emesis induced by cisplatin. An effective treatment for delayed emesis is still needed.     

凝血酶联合顺铂治疗恶性血性胸水

[目的]观察凝血酶联合顺铂治疗恶性血性胸水的疗效.[方法]恶性血性胸水患者46例经胸穿或闭式引流尽量排净胸水,治疗组(23例)向胸腔内注入凝血酶 顺铂,对照组(23例)单纯顺铂胸腔内注入,4周后评价疗效.[结果]治疗组有效率86.9%,对照组有效率仅52.2%(P《0.05).治疗组的KPS评分改善率(78.3%)高于对照组(34.8%),两者差异有显著性(P《0.01).毒副反应均较轻,无需特殊处理.[结论]凝血酶联合顺铂治疗恶性血性胸水疗效较好,而且副反应轻,可安全用于临床.