| Objective:To observe the clinical efficacy of thalidomide on the prevention of delayed nausea and vomiting induced by paclitaxel combined with cis-diamine dichloroplatinum(CDDP)chemotherapy in squamous cell lung carcinoma and its effect on the level of serum substance P(SP),and preliminarily explore the action mechanism of thalidomide on the prevention of delayed nausea and vomiting induced by squamous cell lung carcinoma chemotherapy.Methods:200 patients with lung squamous cell carcinoma confirmed by histopathology in Shaoyang Central Hospital from December 2018 to January2020 who underwent TP scheme(paclitaxel 175mg/m~2 D1+CDDP 25mg/m~2 D1-D3)chemotherapy was selected and randomly divided into two groups:Thalidomide group(100 mg,take orally,twice a day,D1-D5)and control group(100 cases).Both groups were given with palonosetron(0.25mg),and intravenous drip was carried out at 30 min before chemotherapy,D1;dexamethasone,12mg,intravenous drip was carried out at 30 min before chemotherapy,D1,dexamethasone,8mg,take orally,D2-D5.The occurrence of delayed nausea and vomiting(D2-D5)was compared between the two groups.The level of serum substance P in the two groups was detected by enzyme linked immunosorbent assay(ELISA)1 day before chemotherapy(D0),2nd day(D2)and 5th day(D5)after chemotherapy.Results:(1)the difference in the basic situation was not statistically significant between thalidomide group and control group(P>0.05);(2)the differences in the occurrence degree,complete remission rate and effective rate of delayed nausea and vomiting were statistically significant between the two groups(P<0.05);(3)the difference in the level of substance P in serum was not statistically significant between thalidomide group and control group on 1 day before chemotherapy(P>0.05),and the difference in the level of serum substance P was not statistically significant between the two groups on the 2nd and 5th day of the chemotherapy cycle(P<0.05);in the thalidomide group,the level of serum substance P did not increase significantly on 1 day before chemotherapy,2nd and 5th day after chemotherapy,without the significant difference(P>0.05);in the control group,the level of serum substance P increased significantly on 1 day before chemotherapy,2nd and 5th day after chemotherapy,with the significant difference(P<0.01);(4)the difference in the level of serum substance P was statistically significant between effective patients and ineffective patients in the thalidomide group(P<0.05);(5)the differences in the blood routine examination,hepatic and renal function and other related indicators were not statistically significant between the two groups before and during the treatment(P>0.05);The incidence of sedation,somnolence and constipation in the thalidomide group was higher than that in the control group(P<0.01).Conclusion:1.Thalidomide can reduce the incidence of delayed nausea and vomiting induced by paclitaxel combined with CDDP chemotherapy.2.The mechanism of thalidomide preventing delayed nausea and vomiting may be related to the inhibition of serum substance P level. |
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