カルボプラチンをベースとした肺がん化学療法に対するアプレピタントの制吐効果

抄録

Chemotherapy-induced nausea and vomiting (CINV) reduces patient's quality of life and the intensity of treatment. Therefore, the control of CINV is necessary to enable continuation of cancer chemotherapy. Many guidelines on CINV recommend using aprepitant in chemotherapy in cases with high emetogenic risks and in some cases with moderate emetogenic risks. However, there is no report that verifies the efficacy of aprepitant intended for carboplatin with moderate emetogenic risks. We investigated the safety and effectiveness of aprepitant for the prevention of CINV based on carboplatin chemotherapy. Eighty patients with lung cancer who received high dosage (AUC5 or more) carboplatinbased chemotherapy from February 2010 to March 2011 were the subjects of the present study. The administration group was 32 patients who were also administered aprepitant and the control group was 48 patients with no administration of aprepitant. We assessed CINV, use of rescue medication and adverse events during the observation phase. The percentage of patients with no vomiting or no rescue medication at the delay phase was significantly higher in the administration group (96.9% versus 75.0% in the control group). However, the percentage of patients without nausea was not significant between groups, the percentage of patients without nausea of Grade 2 or more was significantly higher in the administration group (96.9% versus 77.1% in the control group). The adverse events were not significant between groups. These results suggest that the addition of aprepitant is useful for the prevention of CINV at the delaying phase in lung cancer patients receiving moderate emetogenic carboplatin-based chemotherapy.