Comparison between Antiemetic Effects of Palonosetron and Granisetron on Chemotherapy-Induced Nausea and Vomiting in Japanese Patients Treated with R-CHOP

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  • Uchida Mayako
    Department of Pharmacy, Kyushu University Hospital Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences
  • Mori Yasuo
    Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
  • Nakamura Tsutomu
    Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences
  • Kato Koji
    Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
  • Kamezaki Kenjiro
    Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
  • Takenaka Katsuto
    Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
  • Shiratsuchi Motoaki
    Department of Medicine and Bioregulatory Science, Kyushu University Graduate School of Medical Sciences
  • Kadoyama Kaori
    Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences
  • Miyamoto Toshihiro
    Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
  • Akashi Koichi
    Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences

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<p>In the present study, the antiemetic effect of palonosetron, not combined with dexamethasone and aprepitant, on chemotherapy-induced nausea and vomiting was evaluated in patients with malignant lymphoma receiving first-line rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy, and was compared to that of granisetron. A total of 74 patients with non-Hodgkin lymphoma were included in this study (April 2007 to December 2015). Palonosetron (0.75 mg) or granisetron (3 mg) was intravenously administered before R-CHOP therapy. The proportions of patients with complete response (CR) during the overall (0–120 h after the start of R-CHOP therapy), acute (0–24 h) and delayed (24–120 h) phases were evaluated. CR was defined as no vomiting and no use of antiemetic rescue medication. A total of 32 and 42 patients were treated with palonosetron and granisetron, respectively. The CR rate in the palonosetron group was significantly higher than that in the granisetron group during the delayed phase (90.6 and 61.9%, respectively; p=0.007). Logistic regression analysis showed that use of palonosetron improved the CR rate during the delayed phase, compared to use of granisetron. Female sex, age less than 60 years, no habitual alcohol intake, and Eastern Cooperative Oncology Group performance status (ECOG-PS) score of 1 were significant risk factors associated with non-CR. The findings of this study suggested the superiority of palonosetron to granisetron, without accompanying dexamethasone and aprepitant, for chemotherapy-induced nausea and vomiting in patients with malignant lymphoma.</p>

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