對化學治療所引起延遲性嘔吐的治療

Effectiveness of Regimens for the Prevention of Delayed Nausea and Vomiting by Chemotherapy

許多化學治療藥物都會引起噁心和嘔吐，令患者不適。雖然最近所使用的5-HT3接受器拮抗劑相當有用，但仍有20-30％患者效果不佳，特別是對延遲性（24-120小時）的噁心、嘔吐。現階段認為，在用高致吐性和中度致吐性的化學治療藥物時，合併使用5-HT3接受器拮抗劑、類固醇、和NK-1拮抗劑已可減少急性的噁心、嘔吐，但對延遲性噁心和嘔吐的預防，使用類固醇和NK-1拮抗劑的天數和劑量則仍待更多的研究。

Many anticancer drugs have debilitating side-effects such as chemotherapy-induced nausea and vomiting. The introduction of 5-hydroxytryptamine 3(5-HT3) receptor antagonist has significantly improved control of chemotherapy-induced nausea and vomiting for patients undergoing treatment for cancer. However, approximately 20-30% of patients still do not respond satisfactory to the 5-HT3 receptor antagonists. Presently, a three-drug combination of a serotonin antagonist, a corticosteroid, and an NK-1 antagonist is approved for the prevention of acute and delayed nausea and vomiting after cisplatin-containing regimens and also after moderately emetogenic chemotherapy. Finally, direct comparison of brief and extended antiemetic regimens to determine the most convenient and feasible strategy for obtaining maximal delayed antiemetic efficacy could lead to improved patient adherence and improved quality of life.