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開催概要
開催回
第53回・2015年・京都
 

MECに伴う5-HT3 RAとdexamethasone併用下でのCINVに関する多施設共同前向観察研究

演題番号 : WS92-5

[筆頭演者]
小暮 友毅:1 
[共同演者]
松井 礼子:2、野上 尚之:1、鈴木 賢一:3、瀧口 友美:3、西尾 誠人:3、小池 健志:2、林 稔展:4、瀬戸 貴司:5、藤原 季美子:6、金田 裕靖:6、原田 知彦:7、木村 仁:8、下川 元継:5、後藤 功一:2

1:独立行政法人国立病院機構四国がんセンター、2:独立行政法人国立がん研究センター東病院、3:公益財団法人がん研究会有明病院、4:独立行政法人国立病院機構九州医療センター、5:独立行政法人国立病院機構九州がんセンター、6:近畿大学医学部附属病院、7:地方独立行政法人神奈川県立病院機構神奈川県立がんセンター、8:静岡県立静岡がんセンター

 

Background: Antiemetic guidelines are recommended combination therapy with a 5-HT3 receptor antagonist(RA) and DEX during MEC. However, it is still not clear what regimens provide poor control of CINV. In this study, we clarified regimens that poorly control CINV due to MEC and the risk factors.
Methods: Patients received combination therapy with a 5-HT3 RA and DEX during MEC, e.g,, in lung cancer: CBDCA+ETP therapy, CBDCA+PTX therapy or CBDCA+PEM therapy, breast cancer: cyclophosphamide plus docetaxel therapy(TC-BC), colon cancer: oxaliplatin with fluorouracil and folinic acid therapy(FOLFOX) or capecitabine plus oxaliplatin therapy(XELOX), ovarian cancer: CBDCA+PTX therapy(TC-OC). Efficacy was assessed from the start of therapy for 7 days. We prospectively evaluated emetic events, administration of rescue therapy and the degree of nausea based on patient diaries.
Results: Between May 2013 and January 2015, 400 patients were registered and 386 were evaluable. The proportion of patients who achieved a complete response(CR; defined as no emetic episodes and no use of rescue therapy), during the overall phase(0-168 h) were as follows: CBDCA+ETP 77%, CBDCA+PTX 67%, CBDCA+PEM 54%, TC-BC 70%, FOLFOX 63%, XELOX 64%, and TC-OC 51%. The proportion of patients who achieved total control(defined as no emetic episodes, no use of rescue therapy and nausea) during the overall phase were as follows: CBDCA+ETP 71%, CBDCA+PTX 57%, CBDCA+PEM 33%, TC-BC 48%, FOLFOX 53%, XELOX 54%, and TC-OC 36%. CR rates were clinically lower in females(56%) compared with males(70%). Overall emetic events were found in 23%.
Conclusions: In MEC, CBDCA+PEM and TC-OC resulted in poorly controlled CINV. We also clarified a low emetic control rate in females. The antiemetic therapy regimens with poorly controlled CINV and females should be considered for triplet antiemetic regimen including a neurokinin-1 RA.
(DEX; dexamethasone, CBDCA; carboplatin, ETP; etoposide, PTX; paclitaxel, PEM; pemetrexed)

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