期刊
SUPPORTIVE CARE IN CANCER
卷 29, 期 9, 页码 5029-5035出版社
SPRINGER
DOI: 10.1007/s00520-021-06061-8
关键词
Antiemetics; Chemotherapy-induced nausea and vomiting; Steroid-sparing; Dexamethasone; Carboplatin; Lung cancer
This study evaluated the efficacy of combining 5-HT(3)RA, APR, and DEX on day 1 of CBDCA-based chemotherapy in lung cancer patients. Results showed that the one-day DEX regimen resulted in poorer control of delayed nausea, recommending careful patient selection when considering DEX-sparing strategies.
Purpose Dexamethasone (DEX)-sparing strategies (one-day DEX) with palonosetron as doublet antiemetic prophylaxis have previously been studied. However, DEX-sparing regimens with 5-hydroxytryptamine-3 receptor antagonist (5-HT(3)RA) and aprepitant (APR), as triplet antiemetic prophylaxis, have not been evaluated. This study aimed to evaluate the efficacy of a combination of 5-HT(3)RA, APR, and DEX on day 1 of carboplatin (CBDCA)-based chemotherapy in patients with lung cancer. Methods Data were pooled from a nationwide, multicenter, prospective observational study using propensity score-matched analysis to compare the incidence of chemotherapy-induced nausea and vomiting (CINV) between one- and multiple-day DEX regimens in combination with 5-HT(3)RA plus APR. Results Incidence of delayed nausea was significantly higher in the one-day than in the multiple-day DEX group. Incidence of nausea was also significantly higher in the one-day than in the multiple-day DEX group on days 3-5. Kaplan-Meier curves for nausea showed a significant difference between the two groups; however, there was no significant difference in the occurrence of vomiting or the Kaplan-Meier curves of time to vomiting. Conclusion To the best of our knowledge, this study is the first to evaluate the efficacy of a DEX-sparing regimen by comparing one- and multiple-day DEX combined with 5-HT(3)RA and APR concerning CINV incidence in lung cancer patients receiving CBDCA-based chemotherapy. Antiemetic regimens of one-day DEX result in poor control of delayed nausea; therefore, we recommend the application of the DEX-sparing strategy only after careful patient selection while considering the development of nausea.
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