| Background and purposeIn recent years,the incidence of cancer in the world gradually increased,has become the main cause of human death,and for patients with advanced cancer,chemotherapy has become the main method of treatment and prolong survival."People talk about cancer",not only because the majority can not cure,but also because of intolerant adverse reactions during chemotherapy,such as nausea,vomiting,hair loss,fatigue,and the chemotherapy inducedd nausea and vomiting(Chemotherapy-induced nausea and vomiting CINV)as patients perceived discomfort,has become the most the adverse reaction of fear.The toxicity of CINV is the most common cancer patients during chemotherapy,greatly affects the quality of life of patients,leading to poor adherence to patients in long-term treatment,resulting in the delay or interruption;in addition,CINV can also lead to depletion of imbalance in patients with metabolic self-awareness and functional status,nutrient reduction,greatly hindered the effective anti-tumor treatment,has become an important challenge in clinical practice.At present on the CINV mechanism,is not particularly clear,it is considered that occurrence and neurotransmitter 5-serotonin in patients with acute CINV(5-HT),the delay occurred with P material CINV(SP)or 5-HT to release.With 5-HT3 receptor antagonists such as tropisetron in a lot of clinical application in the prevention and treatment of CINV CINV,the control rate has been greatly improved,especially the control of acute CINV rate improved a lot in the treatment of patients with nutritional support and mental comfort has been greatly satisfied,but in the control of delay CINV,even if the high-dose application generation 5-HT3 receptor antagonist,has not yet achieved good results.5-HT3 receptor antagonist palonosetron hydrochloride injection or capsule for the second generation,because of the special structure of its molecular rigidity,make it stronger and 5-HT3 receptor binding capacity and longer half-life,can have a greater advantage in the control of delayed CINV;in addition,the latest research suggests that not only palonosetron block the combination of 5-HT and 5-HT3 receptors,at the same time with the change of time and dose,can control the crosstalk between 5-HT3 R and NK-1 receptor pathway to better delayed CINV,which may become Palonosetron by various guidelines recommend theoretical basis for the prevention of drug delayed CINV.Therefore,in order to make the patients can use the least cost,thus achieving the best emetogenic this study by contrasting the effect of palonosetron hydrochloride capsules,palonosetron hydrochloride and tropisetron hydrochloride injection in prevention of chemotherapy,highly emetogenic effects of drug induced nausea and vomiting,to observe the adverse reaction and the use of cost effectiveness analysis principle of pharmacoeconomics of three kinds of drugs,in order to find out an effective and economical treatment in.Materials and methodsIn our hospital in 2015 year 06 months-2016 year 06 hospitalized diagnosed malignant tumor in 90 patients,aged 18-70 years old,mainly take the chemotherapy with cisplatin and adriamycin,were randomly divided into A,B,C three groups,A group adopted palonosetron hydrochloride capsules,group B with hydrochloric acid palonosetron injection,group C was treated with tropisetron hydrochloride injection,the prevention of CINV,was observed in the control of acute CINV,delayed CINV and CINV chemotherapy,the occurrence of adverse reactions,the statistics and the use of cost effectiveness analysis principle of pharmacoeconomics of three different antiemetic schemes.Statistical processingThe obtained data were analyzed using SPSS21.0 statistical software,count data using X-test,measurement data with x± s,by analysis of variance,were less than 0.05 was statistically significant for P value.Results1.General information: a total of 90 patients were randomly divided into A group(palonosetron hydrochloride capsule group)30 cases,B group(palonosetron hydrochloride group)30 cases,group C(tropisetron injection group)30 cases,no significant difference between three groups in age and gender,KPS score,tumor type and other information,comparable.2.Each of the three groups of patients during the control of vomiting: palonosetron capsule,palonosetron and tropisetron hydrochloride injection injection in prevention of acute CINV,CRR were 86.7%,83.3%,73.3%,the difference was not statistically significant,but in the prevention and treatment of delayed CINV,palonosetron injection and capsule the CRR was significantly higher than that of tropisetron hydrochloride injection group was 73.3%,43.3% and 70% vs vs 43.3%(P < 0.05),with a statistically significant difference between the two different formulations of palonosetron in the prevention of delayed CINV,CRR has not made significant difference.CINV CRR the whole period of chemotherapy,three groups were 76.7%,66.7%,36.7%,the same palonosetron group than tropisetron group(P < 0.05),the two different formulations of CRR palonosetron has not made significant difference.3.Adverse reactions of the three groups of patients: A group of discomfort symptoms for 2 cases of fatigue,the incidence rate was 6.7%;B group,2 cases of abdominal distension,dizziness in 1 cases,the incidence rate was 10%,C group of 1 cases of constipation,2 cases of 1 cases of dizziness,fatigue,the incidence rate was 13.3%,the clinical symptoms of the three groups have caused discomfort the incidence,the comparison between no statistical significance(P > 0.05),and slight,too much interference in the clinical treatment is not formed.4.Comparison of three groups of patients with CEA: palonosetron hydrochloride capsule group C/E was the lowest(3.29 + 0,31),followed by palonosetron hydrochloride injection group(6.87 + 0.17),tropisetron group was the highest(9.60 + 0.68),the three groups have significant difference(P <0.05).Conclusion1.Palonosetron hydrochloride capsules and injection can well control CINV by moderate and highly emetogenic chemotherapy with mild adverse reactions,whose delayed CINV complete remission rate were higher than what of tropisetron injection.2.The cost effectiveness analysis shows palonosetron hydrochloride capsules best,palonosetron hydrochloride injection followed were better than tropisetron injection. |
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