Abstract: Objective To evaluate the efficacy of aprepitant for prevention of highlymoderately emetogenic chemotherapy-induced vomiting.
Methods Amomg the cancer patients underwent highlymoderately emetogenic chemotherapy from the January 2014 to December 2014 in the Department of Medical Oncology and Radiotherapy， 120 patients with vomiting of grade 2 or greater and requiring additional antiemetic drugs after treatment with palonosetron plus dexamethasone were chosen during the first cycle of chemotherapy in this study. From second cycle of chemotherapy， each patient received aprepitant (125 mg, d1, 80 mg, d2-d3)， palonosetron (0.25 mg iv, qod) plus dexamethasone (8 mg iv, qd) at 1 h before initiation of highlymoderately emetogenic chemotherapy.
Results All patients in the first cycle had vomiting of grade 2 or greater， and the no-vomiting time in the second cycle after the treatment with aprepitant was prolonged （P＜0.01）. The rate of no vomiting in the first- and secondcycle of chemotherapy was 0 and 59.2％ （71／120）. The incidences of vomiting of grade 1， 2 or 3 were 29.2％ （35／120） and 0， 9.1％ （11／120） and 60.8％ （73／120）， 2.5％ （3／120） and 39.2％ （47／120） during the second- and first-cycle of chemotherapy， respectively. Aprepitant significantly reduced the incidences of vomiting for the patient who suffered it in the first cycle chemotherapy （P＜0.01）. The main adverse reactions including anorexia, weak and constipation were grade 1. Conclusion The triple antiemetic combination with aprepitant can effectively control the emesis in patients receiving highlymoderately emetogenic chemotherapy.