Keywords: 
• aprepitant /
• AC chemotherapy /
• nausea and vomiting /
• secondary prevention /
• breast cancer

Abstract: Objective To evaluate the efficacy and side effects of combination therapy with aprepitant, tropisetron and dexamethasone in the prevention of nausea and vomiting induced by AC chemotherapy in patients after breast cancer surgery. Methods 72 breast cancer patients were selected for this study. Those patients were admitted to the Oncology Department in Dezhou Municipal Hospital from January 2015 to May 2016. The patients were randomly divided into observation group (35 cases) and control group (37 cases). All patients underwent breast cancer surgery and followed by AC program for the first time chemotherapy. Chemotherapy induced nausea and vomiting (CINV) were rated moderate to severe during the course of chemotherapy. The patients in the observation group were treated with aprepitant, tropisetron hydrochloride and dexamethasone to prevent CINV. The control group was treated with tropisetron hydrochloride and dexamethasone. The efficacy and adverse reactions in acute phase (0~24 h) and delay phase (24~120 h) were recorded. Results There was no significant difference in the complete control rate (CR) between the two groups during acute phase (P>0.05). The observation group had significantly higher effective control rate (CR+PR) in acute phase compared to the control group (P<0.05). Both CR and CR+PR were statistically higher in observation group during delay phase (P<0.05). The main adverse reactions in two groups were constipation, fatigue, facial flushing, anxiety and dizziness. Those side effects are considered as mild and tolerable. Conclusion Triple antiemetic therapy including aprepitant has good efficacy and reasonable cost to effect ratio for patients received AC chemotherapy after breast cancer surgery with moderate-severe vomiting. This treatment is easy to accept for those patients.