medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-19-116-121medsovet-2758Research ArticleПоддерживающая терапия в онкологииSupportive care in oncologyОценка эффективности апрепитанта для профилактики тошноты и рвоты у больных раком молочной железыEvaluation of the effectiveness of aprepitant for prevention of nausea and vomiting in patients with breast cancerКоролеваИ. А.KorolevaI. A.

д.м.н., профессор кафедры клинической медицины последипломного образования

КоппМ. В.KoppM. V.

д.м.н., профессор, врач-онколог, ведущий научный сотрудник отдела клинических исследований

КоролеваА. М.KorolevaA. M.

врач-онколог

Медицинский университет «Реавиз», СамараРоссияMedical University «Reaviz», SamaraRussian Federation201811112018019116121Copyright © Королева И.А., Копп М.В., Королева А.М., 20182018Королева И.А., Копп М.В., Королева А.М.Koroleva I.A., Kopp M.V., Koroleva A.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2758

Режим АС (доксорубицин и циклофосфамид) наиболее часто используется при адъювантной химиотерапии рака молочной железы (РМЖ). Режим АС является высокоэметогенным. Цель исследования: оценить эффективность комбинации апрепитант + ондансетрон + дексаметазон для профилактики тошноты и рвоты у больных РМЖ, получающих противоопухолевую лекарственную терапию в режиме АС. Материал и методы: в исследование включены 64 больные РМЖ, получающие адъювантную химиотерапию АС: доксорубицин 60 мг/м2, циклофосфамид 600 мг/м2 в 1-й день, каждые 21 день, 4 цикла. Режим для профилактики тошноты и рвоты в группе 1 (n=34): апрепитант 125 мг внутрь в 1-й день, 80 мг внутрь во 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 во 2–4-й дни. Группа 2 (n=30): ондансетрон 8 мг в/в в 1-й день, дексаметазон 12 мг в/в в 1-й день, затем по 8 мг/сут внутрь во 2–4-й дни. Качество жизни пациенток оценивалось по опроснику Functional Living Index Emesis (FLIE). Результаты: при проведении первого цикла химиотерапии полный контроль тошноты и рвоты достигнут у 20 (58,8%) больных группы 1 и у 4 (13,3%) группы 2 (p < 0,05). Средний балл по шкале FLIE в группе 1 – 19,88, в группе 2 – 38,03 (p < 0,05). Заключение: режим АС требует проведения трехкомпонентной схемы профилактики тошноты и рвоты (антагонист NK-1 рецепторов, антагонист 5-HT3 рецепторов и дексаметазон).

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:64 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 of Group 1 (n=34) 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. Patients of Group 2 (n = 30) received 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). The quality of life of patients was assessed by Functional Living Index of emesis (FLIE). Results: During the first cycle of chemotherapy complete control of nausea and vomiting was achieved at 20 (58,8%) patients of Group 1 and at 4 (13.3%) %) patients of Group 2 (p<0.05). The average score on the Functional Living Index of emesis (FLIE) scale in Group 1 was 19.88, in Group 2-38.03 (p<0.05). Conclusion: Adequate regimen for prevention of nausea and vomiting is combination of NK1 receptor antagonist, 5-HT3 receptor antagonist and dexamethasone.

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