medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-14-112-117medsovet-2175Research ArticleПоддерживающая терапия в онкологииSupportive care in oncologyСХЕМА ХИМИОТЕРАПИИ AC (ДОКСОРУБИЦИН И ЦИКЛОФОСФАМИД) ПРИ РАКЕ МОЛОЧНОЙ ЖЕЛЕЗЫ ПРОФИЛАКТИКА ТОШНОТЫ И РВОТЫCHEMOTHERAPY REGIMEN AC (DOXORUBICIN AND CYCLOPHOSPHAMIDE) IN BREAST CANCER – PREVENTION OF NAUSEA AND VOMITINGКоролеваИ. А.KorolevaI. A.

Доктор медицинских наук, профессор.

Самара

MD, Prof.

Samara

КоппМ. В.KoppM. V.

Доктор медицинских наук, профессор.

Самара

MD, Prof.

Samara

ЛипаеваЕ. М.LipaevaE. M.Медицинский университет «Реавиз»РоссияMedical University ReavizRussian FederationСамарский областной клинический онкологический диспансерРоссияSamara regional clinical oncology dispensaryRussian Federation201714112017014112117Copyright © Королева И.А., Копп М.В., Липаева Е.М., 20172017Королева И.А., Копп М.В., Липаева Е.М.Koroleva I.A., Kopp M.V., Lipaeva E.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2175

Режим АС (доксорубицин и циклофосфамид) наиболее часто используется при адъювантной химиотерапии рака молочной железы. Режим АС является высокоэметогенным.

Цель исследования

Цель исследования: оценить эффективность комбинации «апрепитант + ондансетрон +дексаметазон» для профилактики тошноты и рвоты у больных раком молочной железы, получавших противоопухолевую  лекарственную терапию в режиме АС.

Материалы и методы

Материалы и методы: в исследование включены 82 больных раком молочной железы, получавших адъювантную химиотерапию АС: доксорубицин 60 мг/м2, циклофосфамид 600 мг/м2  в 1-й день, каждый 21 день, 4 цикла. Режим для профилактики тошноты и рвоты: апрепитант 125  мг внутрь в 1-й день, 80 мг внутрь в 2-й и 3-й день, ондансетрон 8 мг в/в в 1-й день, дексаметазон 12 мг в/в 1-й день, затем по 8 мг/сут внутрь в 2–4-й  дни.

Результаты

Результаты: при проведении первого цикла химиотерапии  в острую фазу (0–24 часа от начала химиотерапии) полный контроль тошноты и рвоты достигнут у 87,8% (72) больных. В отсроченную фазу (25–120 часов от начала химиотерапии) полный контроль достигнут у 68,3% (56) больных.  У 57,3% больных полный контроль тошноты и рвоты сохранялся на протяжении 4 циклов АС.

Заключение

Заключение: режим АС требует проведения трехкомпонентной схемы профилактики тошноты и рвоты (антагонист NK-1рецепторов, антагонист 5-HT3-рецепторов и дексаметазон). Проведение адекватной профилактики позволяет более чем половине больных получить четыре цикла химиотерапии АС, не испытав ни одного эпизода тошноты и рвоты, что положительно влияет на выполнение плана терапии при полном контроле эметических расстройств.

Chemotherapy regimen AС (doxorubicin and cyclophosphamide) is the most often used in adjuvant chemotherapy of breast cancer. AC regimen is high emetogenic.

Objective – to evaluate the effectiveness of the combination of aprepitant, ondansetron and dexamethasone for the prevention of nausea and vomiting in patients with breast cancer receiving chemotherapy regimen AC.

Materials and methods

Materials and methods: 82 female patients with breast cancer received adjuvant chemotherapy regimen AC: doxorubicin 60 mg/ m2, cyclophosphamide 600 mg/m2  in day 1, each 21 day 4 cycle. Patients received an triple-therapy regimen (aprepitant 125 mg p.o. in day 1, 80 mg in days 2 and 3, ondansetron 8 mg i.v. in 1 day, dexamethasone 12 mg i.v.in 1 day, then to 8 mg/day p.o. in days 2–4)  for prevention of nausea and vomiting.

Results

Results: During the first cycle of chemotherapy in acute phase (0-24  hours from the start of chemotherapy) complete control of nausea and vomiting was achieved at 72 (87.8%) patients. During delayed phase (25-120 hours from the start of chemotherapy) complete control achieved at 56 (68.3%)patients . 57.3% of patients had complete control of nausea and vomiting during all 4 cycles.

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The authors declare that there are no conflicts of interest present.