Clinical observation of olanzapine in the prevention and treatment of nausea and vomiting caused by cisplatin-based chemotherapy

LIU Yimin; ZHU Lin; DONG Tingting; CAO Lei; LI Shimeng; LIU Delin

doi:10.3969/j.issn.1009-0460.2017.11.015

Abstract：Objective To evaluate the efficacy and safety of olanzapine combined with palonosetron hydrochloride and dexamethasone in prevention of chemotherapy-induced nausea and vomiting(CINV) in cancer patients receiving high emetogenic chemotherapy.Methods A total of 90 patients with malignant tumors treated with cisplatin 3-day regimen were randomly divided into two groups.Patients in low-dose olanzapine group was treated with palonosetron(0.25 mg Ⅳ,d1,d3),dexamethasone(10 mg VD,d1-d4) combined with olanzapine (5 mg po,d1-d4),and patients in high-dose olanzapine group was treated by palonosetron (0.25 mg Ⅳ,d1,d3),dexamethasone(10 mg VD,d1-d4) combined with olanzapine (10 mg po,d1-d4).The complete remission rate and efficiency of acute CINV and delayed CINV in acute phase of two groups were compared,and the efficacy and safety of olanzapine with different dosage in the treatment of nausea and vomiting were evaluated.Results The complete remission rates of acute CINV and delayed CINV in the low-dose group were 70.2％ (33/47) and 63.8％ (30/47),respectively,which were lower than 83.8％ (36/43) and 74.4％ (32/ 43) in the high-dose group,but the difference was not statistically significant (P＞0.05).The effective rates of acute CINV and delayed CINV were similar in the two groups,and the difference was not statistically significant (P＞0.05).The incidence of dizziness and drowsiness in the low-dose group was 8.5％ and 4.3％,which was lower than 27.9％ and 18.6％ in the high-dose group,and the difference was statistically significant (P＜0.05).Conclusion The low dose of olanzapine combined with palonosetron and dexamethasone for the prevention and treatment of high emetogenic chemotherapy nausea and vomiting is better.The incidence of rescue anti vomiting treatment is low,and the adverse reactions are less,which is worthy of clinical recommendation.