Clinical Efficacy And Safety Analysis Of Low-dose Olanzapine Combined With Palonosetron And Dexamethasone In The Prevention Of Nausea And Vomiting Induced By Moderately Emetogenic Chemotherapy

Objective:To evaluate the efficacy and safety of low-dose olanzapine combined with palonosetron and dexamethasone for prevention of chemotherapy-induced nausea and vomiting(CINV)in patients receiving moderately emetogenic chemotherapy(MEC).Methods:A total of 180 patients with gastric cancer and colorectal cancer were included from The First Affiliated Hospital of Nanchang University from January 2017 to January 2019 who received moderately emetogenic chemotherapy.They received low-dose olanzapine combined with palonosetron and dexamethasone(olanzapine 5mg oral qd,d1-3;Palonosetron 0.25 mg,d1;D1-3)to prevent CINV.The main endpoints were the complete response(CR)of CINV during the acute period(24 hours post chemotherapy),the delayed period(days 2-5 post chemotherapy),the whole period(0-120 hours postchemotherapy),and the incidence of adverse events.Results:Complete response of nausea during the acute,delayed and overall period nausewere 90.5%(163/180),74.4%(134/180)and 66.1%(119/180),respectively.CR of vomiting during the acute period,delayed period,and overall period vomitin were 96.7%(174/180),88.3%(159/180)and 86.1%(155/180).The major adverse events included constipation(30.0%,54/180),lethargy(28.3%,51/180),insomnia(11.1%,20/180),anxiety(3.3%,6/180).No grade 3-4 toxicities occured.Conclusion:The regimen of low-dose olanzapine combined with palonosetron and dexamethasone showed good efficacy in preventing nausea and vomiting caused by moderately emetogenic chemotherapy,together with low incidence of adverse events.