盐酸帕洛诺司琼在预防乳腺癌FEC方案化疗中恶心呕吐的疗效观察

目的: 采用盐酸帕洛诺司琼和盐酸托烷司琼来预防乳腺癌FEC方案辅助化疗引起的恶心、呕吐,并对其疗效进行观察。 方法: 选择需要辅助化疗的乳腺癌手术患者42例,术后统一采用FEC方案(氟尿嘧啶、表阿霉素、环磷酰胺)化疗,采用随机自身对照交叉设计方法,将42例患者随机分成AB、BA两组,AB组第一周期化疗前用盐酸帕洛诺司琼0.25 mg止吐,第二周期用盐酸托烷司琼5 mg止吐;BA组第一周期化疗前用盐酸托烷司琼5 mg止吐,第二周期用盐酸帕洛诺司琼0.25 mg止吐。每次化疗后1~4d观察患者的恶心、呕吐情况及其他不良反应。 结果: 42例患者中,使用盐酸帕洛诺司琼止吐时,化疗后24 h内呕吐分级为0度25例,Ⅰ度13例,Ⅱ度3例,Ⅲ度1例,Ⅳ度0例;而使用盐酸托烷司琼止吐时,化疗后24 h内呕吐分级为0度21例,Ⅰ度12例,Ⅱ度5例,Ⅲ度3例,Ⅳ度1例,两组差异有统计学意义(P＜0.05)。使用盐酸帕洛诺司琼止吐化疗后24-96 h内呕吐分级为0度20例,Ⅰ度14例,Ⅱ度7例,Ⅲ度1例,Ⅳ度0例;而使用盐酸托烷司琼止吐化疗后24~96 h内呕吐分级为0度13例,Ⅰ度15例,Ⅱ度9例,Ⅲ度4例,Ⅳ度1例,两组差异有统计学意义(P＜0.01)。使用盐酸帕洛诺司琼与盐酸托烷司琼后防治恶心的疗效及不良反应比较无显著性差异(P＞0.05)。 结论: 盐酸帕洛诺司琼在防治乳腺癌FEC方案辅助化疗所引起的急性及延迟性呕吐的疗效优于盐酸托烷司琼,且安全性好,值得临床推广。

Objective: Palonosetron hydrochloride and tropisetron hydrochloride were used to prevent the nausea and vomiting caused by breast cancer chemotherapy with cyclophosphamide,pharmorubicin and 5-fluorouracil and the efficacy was investigated. Methods: 42 cases with breast cancer receiving chemotherapy with cyclophosphamide,pharmorubicin and 5-fluorouracil after operation were enrolled in this trial.All cases were designed with self-across comparison methods and were randomized into two groups AB group or BA group.Palonosetron hydrochloride was administered to prevent the nausea and vomiting before chemotherapy in AB group when the patients received first course of chemotherapy,tropisetron hydrochloride was administrated during the second course of chemotherapy; On the contrary,tropisetron hydrochloride was administered in BA group when the patients received first course of chemotherapy,palonosetron hydrochloride was administered during the second course of chemotherapy.The situation of nausea and vomiting and adverse reactions were observed and recorded respectively in a period of 4 days after chemotherapy. Results: When palonosetron hydrochloride was administered to prevent the acute vomiting,there were 25 cases with grade 0,13 cases with grade 1,3 cases with grade 2,1 case with grade 3,0 case with grade 4 respectively;while tropisetron hydrochloride was administered to prevent the acute vomiting,there were 21 cases with grade 0,12 cases with grade 1,5cases with grade 2,3 cases with grade 3,1 case with grade 4 respectively;palonosetron hydrochloride was superior to tropisetron hydrochloride in controlling acute vomiting(P＜0.05).When palonosetron hydrochloride was administered to prevent the delayed vomiting,there were 20 cases with grade 0,14 cases with grade 1,7cases with grade 2,1 case with grade 3,0 case with grade 4 respectively;while tropisetron hydrochloride was administered to prevent the delayed vomiting,there were 13 cases with grade 0,15 cases with grade 1,9cases with grade 2,4 cases with grade 3,1 case with grade 4 respectively;palonosetron hydrochloride was superior to tropisetron hydrochloride in controlling delayed vomiting(P＜0.01).There was no significant difference in the adverse reactions and controlling nausea caused by chemotherapy between palonosetron hydrochloride and tropisetron hydrochloride(P＞0.05). Conclusion: Palonosetron hydrochloride was superior to tropisetron hydrochloride in controlling acute and delayed vomiting caused by breast cancer chemotherapy with cyclophosphamide,pharmorubicin and 5-fluorouracil and had few side reaction,and should be advocated in clinical practice.