Efficacy And Pharmacoeconomic Evaluation Of Two Antiemetic Regiments On CINV

Objective:To evaluate two antiemetic regimens which were used in the period of tumor chemotherapy based on the principles of pharmacoeconomics,and to identify a safer,more economical and effective clinical medication treatment for chemotherapy induced nausea and vomiting(CINV).Method:Collected and analyzed retrospectively the cases in the department of oncology of the second affiliated hospital of Guangxi medical university in the period of January 2017 to November 2018,in which patients were treated tumor chemotherapy with oxaliplatin and fluorouracil.All patients were divided into two groups,according to different antiemetic therapies in the treatment of CINV.patients in the tropisetron group were treated with tropisetron combined with dexamethasone for CINV,and patients in the dolasetron group were treated with dolasetron combined with dexamethasone for CINV.Both groups were treated with palonosetron after the first day of chemotherapy.The study need to record and statistically analyze the control of CINV,the degree and frequency of adverse drug reactions(ADR)during the treatment.And then the cost and effectiveness of two antiemetic regiments were evaluated by pharmacoeconomics.Result:1.A total of 135 cases were collected in the study,including sixty-one cases in the tropisetron group and seventy-four cases in the dolasetron group.There was no significant difference between the two groups in age,gender,weight and tumor type(P>0.05).2.The comparison of two groups patients during the control of vomiting:during acute CINV,the remission rates of patients in the group of tropisetron and dolasetron were 78.69%and 89.19%,respectively,which showed no statistical difference(P>0.05).During delayed CINV,the remission rates of patients in the group of tropisetron and dolasetron were 91.80%and 91.89%,respectively,there was no statistical difference of the two groups(P>0.05).And during overall periods of CINV,the vomiting remission rates of patients in group tropisetron and dolasetron were 90.16%and 89.19%,respectively,it was also no significant difference of the two groups(P>0.05).3.Adverse drug reactions of the two groups:the tropisetron group of discomfort symptoms for 1 case of fatigue,1 case of dizziness and 1 case of constipation,the incidence rate was 4.92%.And in the group of dolasetron,there were 2 cases of dizziness and 1 case of diarrhea,the incidence rate was 4.05%.The incidence of discomfort was not significantly different between the tropisetron group and the dolasetron group(P>0.05).The adverse reactions were slight while had no significant effect on the clinical treatment of CINV.4.The coruparison of cost in two groups:the cost of tropisetron,dolasetron group were 169.86,273.91 yuan,respectively.The cost of tropisetron group was cheaper than dolasetron group.Conclusion:l.Both antiemetic therapy with tropisetron,dexamethasone,palonosetron and dolasetron,dexamethasone,palonosetron could effectively control CINV caused by moderate emetogenic chemotherapy regimens.Besides,the two antiemetic regimens demonstrate the good safety profile.And it was similar in the anti-nausea effect during each phase of vomiting.2.With the analysis of pharmacoeconomics,it showed more economic advantages in the antiemetic therapy which involved tropisetron.For patients,who in poor,it could be regarded as a more economical and effective treatment of CINV.