2019 年 45 巻 5 号 p. 262-271
Transcatheter arterial chemoembolization (TACE) for the administration of cisplatin (CDDP) has been established as a standard treatment for unresectable advanced hepatocellular carcinoma (HCC) in Japan. However, no antiemetic therapy for nausea and vomiting caused by TACE has been established. The use of dexamethasone as an antiemetic drug is associated with concerns that reactivation of hepatitis B virus (HBV) may occur in patients with HCC caused by persistent HBV infection. This study was conducted in 100 patients (202 courses) with HCC who received TACE using CDDP, and compared the safety and efficacy of granisetron for 3 days and palonosetron for 1 day in antiemetic therapy without dexamethasone. The total control rates of the granisetron group and the palonosetron group in all courses were 55.4％ and 74.5％ (P < 0.01) in the acute phase, 47.8％ and 65.5％ (P < 0.05) in the late phase, and 42.4％ and 58.2％ (P < 0.05) in the overall phase, respectively. The palonosetron group had significantly better antiemetic therapy than the granisetron group. Constipation was significantly more frequent in the granisetron group (54.3％) than in palonosetron group (39.1％) (P < 0.05), but its severity was only grade 2 or less. The results of this study suggest that a single dose of palonosetron is effective as a preventive measure against nausea and vomiting due to TACE using CDDP.
