Comparative Study Of Different Doses Of Dexamethasone On Prevention And Treatment In The Paclitaxel Combined With Carboplatin Chemotherapy-induced Nausea And Vomiting

Objective :To evaluate the clinical efficacy and safety of the different doses dexamethasone(DXM)combination with ondanstron and olanzapine for prevention and treatment in the paclitaxel combined with carboplatin chemotherapy induced nausea and vomiting(CINV).Methods :Prospective and observational study.In this study,tumor patients receiving paclitaxel combined with carboplatin chemotherapy regimen in the Department of Oncology of the First People’s Hospital of Yunnan Province from June 2020 to February 2021 were included,and the patients were randomly divided into group A,B and C.The antiemetic regimen of group A was:ondansetron 8 mg,i.v.,bid,d 1-d 4;Olanzapine 5 mg,Po,qd,d 1-d 4.The antiemetic regimen of group B was: dexamethasone 5 mg,i.v.,qd,d 1-d 4;Ondansetron 8 mg,i.v.,bid,d 1-d 4;Olanzapine 5 mg,Po,qd,d 1-d4.The antiemetic regimen of group C was: dexamethasone 10 mg,i.v.,qd,d 1-d 4;Ondansetron 8 mg,i.v.,bid,d 1-d 4;Olanzapine 5 mg,Po,qd,d 1-d4.The primary endpoint was the control of nausea and vomiting of patients in the acute phase(0-24 h at the beginning of chemotherapy),the delayed phase(24-120 h at the beginning of chemotherapy),and the total phase(0-120 h at the beginning of chemotherapy),namely the proportion of patients in each group to achieve complete response(CR)and effective response(RR).And the changes of fasting blood glucose in each group before and after dexamethasone treatment,and the factors and total score of Ascension Insomnia scale(athens treatment: the average fasting blood glucose in group A,B and C before dexamethasone treatment was 4.96 ±0.58 mmol/L,5.03 ± 0.49 mmol/L and 5.28 ± 0.78 mmol/L,respectively,with no statistical significance(P > 0.05).After treatment with dexamethasone,the average fasting blood glucose in the three groups was higher than that before treatment(5.30 ± 0.94,mmol/L 5.38 ± 0.5,mmol/L 6.78 ± 11.20 mmol/L,respectively),and the difference was statistically significant(P <0.05).In addition,after dexamethasone treatment,there were differences in the proportion of normal and elevated fasting blood glucose among the three groups,with statistical significance(P < 0.05).5.Before dexamethasone treatment,there were no statistical differences in AIS factors and total AIS score among the three groups(P > 0.05).After dexamethasone treatment,there were significant differences in the time to sleep,night awakening,total sleep quality and total AIS score among groups A,B and C,with statistical significance(P < 0.05).Conclusion :1.In the prevention and treatment of CINV caused by TC chemotherapy regimen,the combined antiemetic regimen of 5 mg and 10 mg dexamethasone combined with ondansetron and olanzapine can effectively control CINV at each stage of chemotherapy.For the controlled treatment of acute nausea,the efficacy of the 10 mg dexamethasone group was significantly better than that of the group without dexamethasone.In the treatment of CINV.2.Tumor patients receiving TC chemotherapy regimen may cause elevated fasting blood glucose,during which the changes in fasting blood glucose should be closely monitored.Treatment with 10 mg dexamethasone for CINV increased posttreatment fasting blood glucose more significantly.3.Patients treated with 10 mg dexamethasone for CINV had a higher incidence of sleep disturbances after treatment.4.Patients treated with 10 mg dexamethasone for the prevention and treatment of CINV had a higher incidence of sleep disorders after treatment.5.The antiemetic regimen of 5 mg dexamethasone combined with ondansetron and olanzapine can effectively prevent and treat CINV caused by TC chemotherapy,with high safety and worthy of clinical promotion.