2018 年第 10 期 第 13 卷

奥氮平联合阿瑞匹坦预防肺癌化疗所致延迟性恶心呕吐的疗效及安全性观察

Clinical efficacy and safety of olanzapine combined with aprepitant in prevention of delayed nausea and vomiting induced by chemotherapy in lung cancer

作者：周锋黄万钟夏瑜彭琼纯

英文作者：

单位：518000广东省深圳市，中山大学附属第八医院（深圳福田）肿瘤内科

英文单位：

关键词：肺肿瘤；奥氮平；阿瑞匹坦；恶心呕吐

英文关键词：

• 摘要：

• 【摘要】目的    探讨奥氮平联合阿瑞匹坦预防肺癌化疗所致延迟性恶心呕吐的临床疗效及安全性。方法    选取2016年2月至2017年12月在中山大学附属第八医院（深圳福田）就诊的中晚期肺癌患者62例。按照随机数字表法分为对照组和观察组，每组31例。2组患者均采取紫杉醇联合顺铂化疗方案及予托烷司琼和地塞米松预防止吐。在此治疗基础上，对照组口服阿瑞匹坦；观察组在对照组基础上加服奥氮平。比较2组化疗24 h后恶心呕吐发生率、化疗前及化疗1周后的生活质量FACT-G量表评分以及治疗过程中的不良反应发生率。结果    观察组延迟性恶心呕吐发生率明显低于对照组［38.7%（12/31）比67.7%（21/31）］，差异有统计学意义（P＝0.042）。化疗1周后，2组生活质量FACT-G量表各项评分均较治疗前降低，观察组FACT-G各项评分明显低于对照组，差异均有统计学意义（均P＜0.01）。治疗过程中观察组呃逆发生率明显低于对照组［12.9%（4/31）比38.7%（12/31）］，嗜睡发生率明显高于对照组［32.3%（10/31）比6.4%（2/31）］，差异均有统计学意义（均P＜0.05）；2组其他不良反应（头痛、乏力、便秘及白细胞减少）发生率比较差异均无统计学意义（均P＞0.05）。结论    奥氮平联合阿瑞匹坦预防肺癌化疗所致延迟性恶心呕吐的疗效明显，且较单用阿瑞匹坦未明显增加不良反应。

• 【Abstract】Objective    To investigate the efficacy and safety of olanzapine combined with aprepitant in prevention of chemotherapy-induced delayed nausea and vomiting in patients with lung cancer. Methods    A total of 62 advanced lung cancer patients were enrolled from February 2016 to December 2017 in the Eighth Affiliated Hospital （Shenzhen Futian）, Sun Yat-sen University; they were randomly divided into control group and observation group, with 31 cases in each group. All patients were treated with paclitaxel plus cisplatin chemotherapy and intravenous administration of tropisetron plus dexamethasone for preventing nausea and vomiting. The control group took aprepitant; the observation group took aprepitant plus olanzapine. Incidence of nausea and vomiting 24 h after chemotherapy, life quality assessed by the FACT-G scale and incidence of drug adverse reactions were analyzed. Results    Incidence of delayed nausea and vomiting in observation group was significantly lower than that in control group［38.7%（12/31） vs 67.7%（21/31）］（P＝0.042）. One week after chemotherapy, FACT-G scores in observation group were significantly lower than those in control group（P＜0.01）. Incidence of hiccup in observation group was significantly lower than that in control group ［12.9%（4/31） vs 38.7%（12/31）］; incidence of drowsiness in observation group was significantly higher than that in control group［32.3%（10/31） vs 6.4%（2/31）］(P＜0.05). Other adverse reactions such as headache, fragile, constipation and leukopenia showed no significant differences between groups(P＞0.05). Conclusion    Olanzapine combined with aprepitant is safe and effective in prevention of chemotherapy-induced delayed nausea and vomiting in patients with lung cancer.