Olanzapine 5 mg for Nausea and Vomiting in Patients with Nasopharyngeal Carcinoma Receiving Cisplatin-Based Concurrent Chemoradiotherapy

Abstract

Purpose. To explore the efficacy and safety of adding olanzapine (5 mg or 10 mg) to 5-hydroxytryptamine type 3 receptor antagonists (5-HT3 RA), neurokinin-1 receptor antagonists (NK1 RA), and dexamethasone for nausea and vomiting in patients with nasopharyngeal carcinoma (NPC) receiving cisplatin-based concurrent chemoradiotherapy. Methods. Patients receiving olanzapine 5 mg or 10 mg combined with 5-HT3 RA, NK1 RA, and dexamethasone during the cisplatin-based concurrent chemoradiotherapy were included. The primary endpoint was the complete response (CR) (no vomiting) rate, and the secondary endpoint was the incidence of no nausea. Results. A total of 150 chemotherapy cycles were administrated for 88 patients (75 in the olanzapine 5 mg group and 75 in the olanzapine 10 mg group). The proportions of CR in the olanzapine 5 mg group were comparable to those in the olanzapine 10 mg group in acute (93.3% vs. 94.7%, P = 0.731 ), delayed (76% vs. 78.7%, P = 0.697 ), and overall phase (73.3% vs. 77.3%, P = 0.570 ). Moreover, no nausea rates were also comparable between the two groups in acute (76% vs. 78.7%, P = 0.697 ), delayed (54.7% vs. 60%, P = 0.509 ), and overall period (50.7% vs. 57.3%, P = 0.111 ). Regarding the adverse effects, the incidence of somnolence in the 10 mg group (58.6%) was significantly higher than that in the 5 mg group (41.3%) ( P = 0.034 ), while constipation (20.0% vs. 24.0%, P = 0.554 ) and hiccups (9.3% vs. 10.6%, P = 0.785 ) rates were comparable in two groups. Conclusions. Patients receiving olanzapine plus standard antiemetic therapy has excellent antiemetic effect in NPC patients receiving cisplatin-based concurrent chemoradiotherapy, and patients with olanzapine 5 mg have a similar antiemetic effect and lower adverse effects compared with those with olanzapine 10 mg.

Effect of Stereotactic Body Radiation Therapy Combined with Thermoplastic Fixation on Set-Up Errors in Breast Cancer Patients Undergoing Radiotherapy

“…The thermoplastic fixation makes up for the deficiencies of conventional fixation. The head mask and baseplate in the thermoplastic fixation can effectively fix the patients to make them feel comfortable and safe during treatment, and the groove and fixing lugs in the baseplate not only facilitate the fixation of headrest but also increase the comfort level [21][22][23]. Besides, Tokunaga et al [24] have pointed out that thermoplastic fixation has remarkably smaller set-up errors compared with the breast bracket and can effectively enhance radiotherapy effect and benefit the patients' prognoses.…”