Clinical Study Of Thalidomide In The Prevention Of Delayed Vomiting Induced By Highly Emetogenic Chemotherapy

ObjectiveTo observe the effificacy of thalidomide(75mg,after dinner once a day)combined with ondansetron and prednisone compared with ondansetron and prednisone on delayed vomiting(24-120 h after chemotherapy)caused by highly emetogenic chemotherapy.Methods79 patients with HEC and who had good compliance in the First Affiliated Hospital of Dali University from May 2019 to May 2020 were divided into control group and THD group,37 patients in control group were given ondansetron and prednisone 24 hours after chemotherapy,42 patients in THD group were given ondansetron,prednisone and thalidomide 24 hours after chemotherapy.SPSS 19.0 statistical software is used for statistical analysis.Results1.After treatment,the vital signs of the THD group and the control group were stable,and the performance status was no deteriorate.2.In the control group there were 11 cases(29.73%)which achieved complete remission(CR)in the prevention of delayed vomiting and 22 cases(52.38%)in the THD group,P=0.042.3.In the control group the ORR was 70.27% in the prevention of delayed vomiting and88.10% in the THD group,P=0.049.4.All the adverse reactions of the two groups were 1-2 grade,tolerable,no grade 3 or severer adverse events,and no thalidomide-related severe adverse events.5.16 cases(43.24%)suffered from constipation in control group and 27 cases(64.29%)in THD group,the difference was not statistically significant(P=0.06);6.10 cases(27.03%)suffered from dry mouth in control group,and 25 cases(59.52%)in THD group,the difference was statistically significant,P=0.004;7.There were 13 cases(35.14%)of peripheral neuropathy in control group and 10cases(23.81%)of eripheral neuropathy in THD group,P=0.27;8.11 cases(29.73%)suffered from anorexia in control group,and 5 cases(11.90%)in THD group.P=0.049;9.12 cases(32.43%)suffered from insomnia in control group,and 7 cases(16.67%)in THD group.The incidence of insomnia in the THD group was significantly lower than that in the control group,but the difference was not statistically significant,P=0.102.Conclusion1.After treatment,all the patients had the same performance status and vital signs in the THD group and the control group were stable.Treatment with thalidomide increased the CR and ORR to delayed vomiting compared with ondansetron and prednisone only.2.All the adverse reactions of the two groups were 1-2 grade.The incidence of dry mouth in the THD group was higher than that in the control group.The incidence of anorexia was lower than those of the control group,it may indicate better quality of life.