シスプラチン化学療法における吃逆の危険因子に関する検討
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Hiccups often occur in patients receiving cisplatin (CDDP)-based chemotherapy. In the present study, we investigated the incidence of hiccups in 162 patients who received CDDP as well as risk factors for developing hiccups. Hiccups occurred in 40 (25%) of the 162 patients, and 93% were men. Twenty-six of the patients had hiccups within 48hr of CDDP, and in 31 of them the hiccups continued for between 1 and 4 days. Twenty-eight of the patients received medication (shitei-decoction, chlorpromazine, metoclopramide, etc.) to relieve hiccups, which was effective in 30% of them. Hiccups developed in patients with osteochondro sarcoma (56%), lung cancer (49%), pancreatic cancer (40%) and esophagus cancer (23%) receiving the following 4 chemotherapy regimens: CDDP+ADM+CAF (56%), CDDP+DTX (50%), CDDP+5FU (40%), and CDDP+TS 1 (20%) respectively. The CDDP dosage (mg/m^2) was higher in patients who had hiccups than in those who had none (80±22 vs 45±33, p<0.0001) and there was a positive correlation was between CDDP dosage and incidence of hiccups (p<0.001), though all patients developing them received corticosteroids and 5 HT_3 antagonists. Multiple logistic regression analysis showed that there were significant differences for the male sex (odds ratio (OR)=8, 95% CI=1.5-45.6), CDDP dose (1.03, 1.01-1.06), dexamethasone (≧16mg) (19.4, 3.9-95.2) and granisetron (6mg) (20.9, 3-143). We therefore concluded that the independent risk factors influencing the development of hiccups were the male sex and a high dose of CDDP in combination with dexamethasone (≧16mg), and granisetron (6mg).
- 2009-02-10
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