内容紹介
Impact of Preventive Administration of Antiemetic Drugs on Risk of Acute Nausea and Vomiting Induced by Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinomas―A Retrospective Study
Summary
This study aimed to evaluate the impact of the preventive administration of antiemetic drugs on the risk of acute nausea and vomiting induced by transcatheter arterial chemoembolization(TACE)in patients with hepatocellular carcinomas(HCCs). From January 2007 to June 2009, a total of 536 patients with HCCs who underwent TACE with a mixture of iodized oil, epirubicin, and porous gelatin particles were included in this retrospective study. Of those patients, 23 out of 357(6.4%)who had received the 5-HT3 receptor antagonist before TACE, and 18 out of 179(10.1%)without the medication, experienced vomiting. The multivariate logistic regression model with a predictive success of 92.4% for vomiting identified significant associations between female gender(odds ratio: 3.73, p<0.001), the number of tumors(1.29, p<0.01), and administration of pentazocine(11.70, p<0.05)with the risk of vomiting. In contrast, the preventive administration of antiemetic drugs was not included in the model as a significant predictive variable. We therefore conclude from this retrospective study that the 5-HT3 receptor antagonist did not significantly contribute to preventing the TACE-induced emesis.
要旨
当施設にて,肝細胞癌に対する経カテーテル的肝動脈化学塞栓術(TACE)を施行した症例のうち,エピルビシン,リピオドール,多孔性ゼラチン粒を使用した536例を対象に,制吐剤の術前予防的投与と急性嘔吐発症の関係について後方視的解析を行った。TACE術前の5-HT3受容体拮抗剤投与群では367名中23名(6.4%)が,また非投与群では179名中18名(10.1%)が発症した。患者因子16項目と嘔吐発症に関する多重ロジスティック解析を行ったところ,得られた嘔吐予測モデルの的中率は92.4%であり,影響を与える有意な因子として,女性(オッズ比3.73),病変数(オッズ比1.29),ペンタゾシン投与(オッズ比11.70)が含まれていた。一方,制吐剤の術前投与については予測モデルに含まれず,ゆえに嘔吐発症に有意な影響を与えているとはいえなかった。本研究の対象症例においては,5-HT3受容体拮抗剤による術前の制吐療法の有効性は示されなかった。
目次
Summary
This study aimed to evaluate the impact of the preventive administration of antiemetic drugs on the risk of acute nausea and vomiting induced by transcatheter arterial chemoembolization(TACE)in patients with hepatocellular carcinomas(HCCs). From January 2007 to June 2009, a total of 536 patients with HCCs who underwent TACE with a mixture of iodized oil, epirubicin, and porous gelatin particles were included in this retrospective study. Of those patients, 23 out of 357(6.4%)who had received the 5-HT3 receptor antagonist before TACE, and 18 out of 179(10.1%)without the medication, experienced vomiting. The multivariate logistic regression model with a predictive success of 92.4% for vomiting identified significant associations between female gender(odds ratio: 3.73, p<0.001), the number of tumors(1.29, p<0.01), and administration of pentazocine(11.70, p<0.05)with the risk of vomiting. In contrast, the preventive administration of antiemetic drugs was not included in the model as a significant predictive variable. We therefore conclude from this retrospective study that the 5-HT3 receptor antagonist did not significantly contribute to preventing the TACE-induced emesis.
要旨
当施設にて,肝細胞癌に対する経カテーテル的肝動脈化学塞栓術(TACE)を施行した症例のうち,エピルビシン,リピオドール,多孔性ゼラチン粒を使用した536例を対象に,制吐剤の術前予防的投与と急性嘔吐発症の関係について後方視的解析を行った。TACE術前の5-HT3受容体拮抗剤投与群では367名中23名(6.4%)が,また非投与群では179名中18名(10.1%)が発症した。患者因子16項目と嘔吐発症に関する多重ロジスティック解析を行ったところ,得られた嘔吐予測モデルの的中率は92.4%であり,影響を与える有意な因子として,女性(オッズ比3.73),病変数(オッズ比1.29),ペンタゾシン投与(オッズ比11.70)が含まれていた。一方,制吐剤の術前投与については予測モデルに含まれず,ゆえに嘔吐発症に有意な影響を与えているとはいえなかった。本研究の対象症例においては,5-HT3受容体拮抗剤による術前の制吐療法の有効性は示されなかった。