Olanzapine 緩解 Trabectedin合併放射線治療軟組織肉瘤病人引起的噁心嘔吐

Olanzapine in Alleviating Nausea and Vomiting Induced by Trabectedin Combined with Radiotherapy in a Patient with Soft Tissue Sarcoma

軟組織肉瘤（soft tissue sarcoma, STS）是一種罕見且異質性高的惡性腫瘤，治療選擇有限。trabectedin作為較新的化療藥物，對晚期STS顯示出潛在療效。本案例探討1位39歲女性腹腔橫紋肌肉瘤合併骨轉移病人，在接受trabectedin合併高劑量放射線治療時，出現嚴重噁心及嘔吐。即便使用預防性止吐藥物，個案仍經歷3級嚴重不良反應。醫療團隊透過多種止吐藥物和營養支持，將噁心及嘔吐程度降至1級，提升治療耐受性和效果。olanzapine在其中發揮了關鍵作用，有效緩解化學治療及放射線治療引超的噁心及嘔吐，顯著改善個案生活品質。調整用藥策略後，個案在後續療程中的不良反應顯著減少，顯示trabectedin在晚期STS治療中的潛力，並強調有效管理不良反應的重要性。該案例強調針對噁心及嘔吐的多藥聯合治療策略，特別是olanzapine的使用，對提升病人治療耐受性和生活品質，具有重要意義。

Soft tissue sarcoma (STS) is a rare and highly heterogeneous malignant tumor with limited treatment options. Trabectedin, a newer chemotherapeutic agent, has shown potential efficacy in advanced STS. This case study involves a 39-year-old female patient with abdominal rhabdomyosarcoma and bone metastasis, who experienced severe nausea and vomiting during treatment with trabectedin combined with high-dose radiotherapy. Despite the use of prophylactic antiemetics, the patient suffered grade 3 severe adverse reactions. The medical team employed a combination of antiemetic drugs and nutritional support to reduce the nausea and vomiting to grade 1, thereby improving treatment tolerance and effectiveness. olanzapine played a crucial role in this process, effectively alleviating chemoradiotherapy-induced nausea and vomiting, significantly enhancing the patient's quality of life. Following an adjustment in medication strategy, the patient's adverse reactions in subsequent treatment cycles were markedly reduced, demonstrating trabectedin's potential in advanced STS treatment and underscoring the importance of effective adverse reaction management. This case highlights the significance of a multi-drug antiemetic strategy, particularly the use of olanzapine, in improving patient treatment tolerance and quality of life.