Prevention of chemotherapy-induced emesis with granisetron in children with malignant diseases.

Y Miyajima, S Numata, I Katayama, K Horibe
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引用次数: 20

Abstract

Purpose: In a prospective crossover study, we evaluated the safety and antiemetic activity of granisetron, a 5-hydroxytryptamine3 (5-HT3) receptor antagonist, compared with conventional antiemetics regimen, including metoclopramide, in pediatric cancer patients.

Patients and methods: Twenty-two children with malignant diseases were enrolled. The chemotherapy included cytarabine 3 g/m2 (regimen A), cisplatin 90 mg/m2 (regimen B), and actinomycin D 900 micrograms/m2 plus ifosfamide 3 g/m2 (regimen C). Granisetron 40 micrograms/kg was infused over 30 min just before each chemotherapy treatment.

Results: A complete response was obtained more often with granisetron than with conventional antiemetics (59.1% vs. 0%, p < 0.001). In terms of efficacy by chemotherapy type, complete response with granisetron was obtained in eight of 10 patients with regimen A, three of eight with regimen B, and two of four with regimen C. Major efficacy (vomiting fewer than two times) was also obtained more with granisetron than with conventional antiemetics (81.8% vs. 4.6%, p < 0.001). The number of vomiting episodes in the first 24 h was less with granisetron than with conventional antiemetics (1.1 +/- 1.46 vs. 9.0 +/- 4.97, p < 0.001). Normal appetite and activity were retained in more patients with granisetron than with conventional antiemetics. Extrapyramidal reactions, akathisia, and sedation were not seen in any case with granisetron.

Conclusions: Granisetron 40 micrograms/kg is well tolerated and more effective than are conventional antiemetic regimens containing metoclopramide for children receiving cancer chemotherapy.

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格拉司琼预防恶性疾病患儿化疗致呕吐的研究。
目的:在一项前瞻性交叉研究中,我们评估了5-羟色胺3 (5-HT3)受体拮抗剂格拉司琼(granisetron)在儿科癌症患者中的安全性和止吐活性,并与包括甲氧氯普胺在内的传统止吐方案进行了比较。患者和方法:纳入22例恶性疾病患儿。化疗方案包括阿糖胞苷3g /m2(方案A),顺铂90mg /m2(方案B),放线菌素D 900微克/m2 +异环磷酰胺3g /m2(方案C),格拉司琼40微克/kg在每次化疗前30 min输注。结果:格拉司琼的完全缓解率高于常规止吐药(59.1%比0%,p < 0.001)。就化疗类型的疗效而言,10例A方案患者中有8例格拉司琼完全缓解,8例B方案患者中有3例,4例c方案患者中有2例。格拉司琼的主要疗效(呕吐次数少于2次)也高于常规止吐药(81.8% vs. 4.6%, p < 0.001)。格拉司琼组前24小时呕吐次数少于常规止吐药组(1.1 +/- 1.46 vs 9.0 +/- 4.97, p < 0.001)。使用格拉司琼的患者比使用常规止吐药的患者保留了更多的正常食欲和活动。格拉司琼未见锥体外系反应、静坐障碍和镇静。结论:40微克/千克格拉司琼对儿童癌症化疗耐受良好,且比含甲氧氯普胺的常规止吐方案更有效。
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