Effect And Adverse Reactions Of Different Doses Of Olanzapine In The Treatment Of Chemotherapy-induced Nausea And Vomiting

Objective To observe the antiemetic efficacy and adverse reactions of different doses of olanzapine in the treatment of moderate and high emetogenic Chemotherapy for nausea and vomiting,and to explore the difference of the best individualized dose and safety of olanzapine in the treatment of CINV.Methods A total of 153 patients with malignant tumor who were hospitalized in the Department of Oncology of the First People’s Hospital of Yunnan Province from July 2020 to February 2021 and received moderate or high emetogenic chemotherapy regimen were enrolled.In this study,three antiemetic regiments were used for prophylaxis: olanzapine(1.25 mg PO,qd,d1-4;2.5mg PO,qd,D1-4;5mg PO,qd,d1-4)combined with tolansetron injection 4mg iv,qd,d1-4 and dexamethasone injection 5mg iv,qd,d1-4.Since the day of chemotherapy according to the WHO antitumor drug toxicity reaction degree standard assessment between groups of patients with nausea and vomiting,until the fifth day after chemotherapy,groups are calculated separately,and the entire period(d1-5),acute phase(d1),the delay of nausea and vomiting(d2-5)efficiently,and through the X2 test and t test,comparing three sets of samples between the basic clinical data,To evaluate the efficacy of different antiemetic schemes in treating nausea and vomiting.Result The effective control rates of nausea and vomiting in 1.25 mg group,2.5mg group and 5mg group were 94.00%,98.07% and 100.00% respectively(P=0.013 < 0.05).The effective rate of acute vomiting was 76.00%,90.38% and 96.07%(P=0.007 < 0.05).The control rates of delayed vomiting were 80.00%,88.46% and 96.07%(P=0.005 < 0.05).The incidence of adverse reactions was: There were 5 cases of constipation(10%)and 2 cases of somnolence(4%)in the 1.25 mg group,6 cases of constipation(11.54%)and 2 cases of somnolence(3.85%)in the 2.5mg group,13 cases of constipation(25.49%)and 2 cases of somnolence(3.92%)in the 5mg group.No extrapypyramidal reaction was observed in the three groups on average(P=0.017 < 0.05 for constipation;Drowsiness P= 0.301> 0.05).Conclusion Through this study,it was found that three doses of olanzapine had good efficacy for CINV;The control rate of 1.25 mg for acute and delayed CINV was lower than that of the other two groups.Compared with 1.25 mg and 2.5mg groups,5mg group had better antiemetic efficacy,but the incidence of adverse reactions to constipation was significantly higher than that of the other two groups.