欧必亭加甲基强的松龙预防化疗所致恶心呕吐

[目的]观察欧必亭与甲基强的松龙联用预防含顺铂的联合化疗所致恶心、呕吐及毒副反应,并与单用欧必亭比较。[方法]采用随机、交叉、自身对照方法,将 36例接受含顺铂的联合化疗的恶性肿瘤患者,随机分为 A、B两组从组第1周期用欧必亭,第2周期用欧必亭加甲基强的松龙;B组第1周期用欧必亭加甲基强的松龙,第2周期用欧必亭。止吐方案;欧必亭5mg,静注,第1-3天,甲基强的松龙120mg,静注,第1-3天。[结果]欧必亭加甲基强的松龙（联合组）第1-6天无恶心和轻度恶心发生率均高于单用欧必亭（单用组）,其中第2-4天差异有显著意义（P<0.05）。急性呕吐（第1天）完全控制率（CR率）联合组为94.4％,有效率为97.2％,单用组为77.8％和86.1％,联合组高于单用组（P<0.05）。迟发性呕吐（第2-4天）CR率和有效率联合组均高于单用组。两组的副作用均较轻。[结论]甲基强的松龙能增强欧必亭对含顺铂化疗所致的恶性、呕吐的控制,可作为预防和控制含顺铂联合化疗所致恶心、呕吐的一线治疗方案。

Comparison of Tropisetron Versus Tropisetron Plus Methylprednisolone in Prevention of Chemotherapy Induced Emesis

[Purpose]To evaluate the efficacy and toxicity of tropisetron and its combination with methylprednisolone in prevention of cisplatin based chemotherapy induced emesis, and compared with tropisetron alone. [Methods] Thirty-six patients who received two consecutive courses of cisplatin based chemotherapy were randomized into group A(tropisetron 5mg intravenously day1 - 3 plus methylprednisolone 120mg intravenously day1 - 3), or group B(tropisetron 5mg intravenously day1 - 3) . [Results] Completed response(CR)was obtained on day 1 in 94.4%of patients who received the combination schedule versus 77.8% of those who received tropisetron alone(P < 0.05) , and in 69.4% - 80.6% versus 22.2% -44.7% on day 2 to 4(P < 0.05).The overall response rates(day 1 to 4)were 88.9% -97.2% versus 72.2% - 86.1%(P <0.05) . Additionally,significantly less nausea was observed in the combination group on day 2 to 4. Adverse effects were mild and well tolerated without significant differences between two groups. [Conclusion] Methylprednisolone can enhance the efficacy of tropisetron in cisplatin based chemotherapy induced emesis. It is suitable as first-line therapy (combined with a methylprednisolone) for the prevention of acute nausea and vomiting in patients treated with moderately to severely emetogenic chemotherapeutic agents.