EFFECT OF TROPISETRON COMBINED WITH OLANZAPINE AND DEXAMETHASONE ON VOMITING AND NAUSEA INDUCED BY CHEMOTHERAPY IN PATIENTS WITH GASTRIC CANCER AND ITS INFLUENCE ON NUTRITIONAL STATUS AND INFLAMMATORY STRESS

YaJun Cheng*, Wei Li**, #

*Department of Gastroenterology, Lianshui County People's Hospital, Huai’an, PR China - **Department of Radiation Oncology,  the  Affiliated Huai'an Hospital of Xuzhou Medical College, Huai'an, PR China

bjective: To explore the effect of tropisetron combined with olanzapine and dexamethasone on malignant vomiting caused by chemotherapy in patients with gastric cancer, and its effect on the patient’s nutritional status and inflammatory stress. 

Methods: Ninety-six patients with gastric cancer who received chemotherapy in our hospital from January 2017 to April 2018 were equally divided into two groups: a control group and an experimental group. The patients in the control group were given an intravenous injection of 5 mg of tropisetron and 5 mg of dexamethasone twice a day for two weeks. The experimental group, on the other hand, was given 5 mg of olanzapine orally twice a day for two weeks. Subsequently, the clinical effects and adverse reactions were compared between the two groups. For example, Albumin (ALB), prealbumin (PAB), transfererrin (TF), immunoglobulin A (IgA), IgG, IgA, interferon-gamma (TNF-α), tumour necrosis factor-alpha (TNF-α), interleukin-4 (IL-4), interleukin-1 were compared before and after treatment. 0 (IL-10) change. The levels of Keich-like epichlorohydrin-related protein-1 (Keap1), nuclear factor E2 (Nrf2), antioxidant response element (ARE), quinone oxidoreductase (NQ01) and heme oxygenase-1 (HO-1) were also measured, via Radioimmunoprecipitation, before and after treatment.

Results: The effective rate in the experimental group was 93.75%, which is significantly better than that of the control group (72.92%; P<0.05). After treatment, the levels of ALB, PAB and TF in the two groups were significantly higher than those before treatment (P<0.05), and the levels of ALB, PAB and TF in the experimental group were significantly higher than those in the control group (P<0.05), as shown in Table 2. After treatment, the levels of IgA, IgG and IgM in the two groups were significantly higher than those before treatment (P<0.05), and the levels of IgA, IgG and IgM in the experimental group were significantly higher than those in the control group (P<0.05). After treatment, the levels of Keap1 in the two groups were significantly higher than those before treatment (P<0.05), and the levels of Nrf2, ARE, NQO1 and HO-1 were significantly lower than those before treatment (P<0.05). Moreover, the levels of Keap1 in the experimental group were significantly higher than those in the control group (P<0.05), while the levels of Nrf2, ARE, NQO1 and HO-1 in the experimental group were significantly lower than those in the control group (P<0.05). After treatment, the levels of IFN-gamma, TNF-alpha, IL-4 and IL-10 in the two groups were significantly lower than those before treatment (P<0.05), and the levels of IFN-γ, TNF-α, IL-4 and IL-10 in the experimental group were significantly lower than those in the control group (P<0.05). Lastly, no significant difference was observed in the incidence of adverse reactions between the two groups (P>0.05). 

Conclusion: Tropisetron combined with olanzapine and dexamethasone can effectively reduce incidences of nausea and vomiting, improve nutritional status and reduce inflammatory stress in patients with chemotherapy-induced gastric cancer.