Efficacy Of Netupitant-palonosetron Combined With Thalidomide In The Prevention Of Highly Emetic Chemotherapy-induced Nausea And Vomiting

Objective:To observe the safety and efficacy of Netupitant-palonosetron(NEPA)combined with thalidomide in preventing nausea and vomiting(CINV)caused by highly emetic chemotherapy drugs.Methods: According to the admission criteria,75 patients with malignant solid tumors who received chemotherapy for the first time in our hospital and applied the highly emetic chemotherapy regimen were divided into two groups by random number table method,including 36 cases in thalidomide combined with NEPA group and 39 cases in dexamethasone combined with NEPA group.Main endpoints: Complete remission rate of vomiting in acute stage,delayed stage and total observation stage;Incidence of patients with no nausea and No significant nausea(NSN)in acute stage,delayed stage and total observation period.Secondary endpoint: the difference of adverse reactions;The influence of CINV on daily life after treatment;Incidence rate of daily CINV events.Results:1.The complete remission rates of vomiting in the thalidomide group and dexamethasone group were 80.6% and 87.2% in the acute phase,77.8% and 74.4% in the delayed phase,and 72.2% and 71.8% in the total observation period,respectively.There were no significant differences(P > 0.05).2.The incidence of nausea-free patients in thalidomide group and dexamethasone group was 66.7% and 69.2% in acute phase,63.9% and 53.8% in delayed phase,and61.1% and 48.7% in total observation period,with no significant difference(P > 0.05).Thalidomide group and dexamethasone group accounted for 83.3% and 87.2% of patients with NSN in acute phase,80.6% and 76.9% in delayed phase,and 75.0% and71.8% in total observation period.There was no significant difference(P > 0.05).3.In terms of adverse reactions,the incidence of constipation in thalidomide group is higher than that in dexamethasone group,and the incidence of insomnia,abnormal blood pressure and abnormal blood sugar in dexamethasone group is higher than that in thalidomide group,with statistically significant differences(P < 0.05),and the adverse reactions are mild.4.Based on the Vomiting Functional Life Scale,the proportion of patients who had no influence on daily life was 77.8% in thalidomide group and 74.4% in dexamethasone group,with no significant difference(P =0.729).Conclusion:1.The two groups have the same effect in preventing highly emetic CINV.2.There are some differences in adverse reactions between the two groups.The incidence of constipation in thalidomide group is higher than that in dexamethasone group,and the incidence of insomnia,abnormal blood pressure and abnormal blood glucose in dexamethasone group is higher than that in thalidomide group.After the two groups of preventive treatment,the proportion of patients whose CINV has no influence on daily life is equal.3.Thalidomide combined with NEPA is an alternative choice for cancer patients with insomnia,hypertension and diabetes,or patients with potential risks after using dexamethasone.