实体瘤儿童化学疗法诱导的恶心和吐的事实调查和风险因素分析:一项前性观察性研究
Miaomiao Shao1,2, Ying Li3, Jing Qin4
1Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China. shaokew@163.com.
BMC pediatrics
|January 31, 2025
概括
化学疗法诱导的恶心和吐 (CINV) 控制在接受高排泄性化疗 (HEC) 的固体瘤儿童中是不理想的. 高龄,女性性别和更长的化疗时间是控制吐的危险因素. 组合抗药改善了控制.
科学领域:
- 儿科瘤学 儿科瘤学
- 临床药理学 临床药理学
- 癌症治疗方法 癌症治疗方法
背景情况:
- 急性化疗诱导的恶心和吐 (CINV) 是儿科瘤学的一个重大挑战,影响治疗坚持和生活质量.
- 高排泄性化疗 (HEC) 方案在患有固体瘤的儿童中具有严重恶心和吐的实质性风险.
- 优化抗策略对于改善患者的治疗结果和癌症治疗的耐受性至关重要.
研究的目的:
- 为了评估急性化疗诱导的恶心和吐 (CINV) 的控制,在经过高排泄性化疗 (HEC) 的固体瘤的儿科患者中.
- 确定与化疗诱导吐 (CIV) 相关的风险因素,以加强CINV管理策略.
- 评估不同抗疗法的有效性,以实现完全控制CINV.
主要方法:
- 从181名 (1-18岁) 用HEC.治疗的固体瘤的儿童收集前性数据.
- 使用结构化日记和儿科恶心评估工具 (PeNAT) 来记录CINV和恶心严重程度.
- 采用单变量和多变量逻辑回归来确定化学疗法诱导吐 (CIV) 完全控制的风险因素.
主要成果:
- 总体而言,52.5%的儿童实现了完全的急性期CIV控制.
- 在4岁以上的儿童中,完全控制CINV的患者为27.9%,CIV控制为41.9%,CIN控制为34.9%.
- 完全控制CIV的显著风险因素包括年轻的年龄,女性性别,更长的化疗持续时间,以及使用5-hydroxytryptamine-3受体对抗剂 (5HT3RA) 加上德克萨.
结论:
- 化学疗法诱导的恶心和吐 (CINV) 控制在接受HEC.固体瘤的儿科患者中仍然不理想.
- 年龄,性别,化疗持续时间和特定的抗emetic疗法 (5HT3RA + dexamethasone) 显著影响CIV控制.
- 以既定协议和患者特定因素为指导的个性化CINV管理策略,对于改善结果和生活质量至关重要.
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