婦人科がん化学療法による嘔気・嘔吐に対するdexamethasoneの効果

抄録

Nausea and vomiting are two of the most unpleasant adverse effects associated with the use of antineoplastic agents and many patients regard them as the most stressful aspect of their disease, more stressful than even than the prospect of dying. Cisplatin, one such agent, is well known for having an emetic potential of almost 100% when administered to patients without emesis prophylaxis. The nausea it causes is the delayed-type and is hard to suppress completely with 5-HT₃ antagonists. Dexamethasone (DEX) is often an effective antiemetic for cisplatin-induced nausea and vomiting, either by itself or in combination with other antiemetics. Though patients were receiving cisplatin under our regimen it did not include DEX.
We therefore investigated the effects of DEX in patients with uterine cervix cancer who were being treated with a regimen including cisplatin. DEX reduced the degree of nausea and frequency of vomiting and increased appetite. It also improved the cost-effectiveness of the regimen. Based on these results, gynecologists in our hospital decided to include DEX in the cisplatin regimen.
We feel that DEX should be the antiemetic drug of choice for cisplatin-regimens and in future, drug regimens should be specifically designed for each patient depending on the cause of nausea and vomiting, and the available evidence.