International Journal of Hematology-Oncology and Stem Cell Research 2009. 3(2):27-30.

A Randomized Comparison of Granisetron Plus Dexamethason with Granisetron alone for the Control of Acute Chemotherapy-Induced Emesis and Nausea
Shahrbanou Keyhanian, O Taziki, MM Saravi, Z Fotokian

Abstract


Introduction: Chemotherapeutic drugs used to treat cancer may cause nausea and emesis by inducing the release of 5-hydroxytryptamine (5-HT) in the small intestine. Blockage of 5-HT3 receptors in the small intestine by 5-HT3 receptor antagonists might prevent the nausea and vomiting associated with chemotherapy for cancer. The aim of this study was to compare the efficacy and tolerability of the 5-HT3 receptor antagonists (granisetron) and granisetron plus dexamethasone in the treatment of acute chemotherapy induced digestive emesis and nausea.
Materials and Methods: Patients on their first course of emetic chemotherapy (cisplation or doxorubicin based regimen) were randomly placed into two treatment groups. Group A received a one-time administration of granisetron 3 mg, IV and group B received granisetron plus dexamethasone 8 mg IV. For each study the drug were administered one time, 30 minutes before infusion of chemotherapy emetic agent. For the efficacy assessment, response data were recorded every 6 hours for a total of 24 hours, after the start of the chemotherapy infusion.
Results: A total of 138 patients [86 males, 52 females with amean age of 48 (a range between 15-82 years)] were involved in the study . Of these, 125 were evaluable.
Discussion: The ability of granisetron plus dexamethason to prevent acute emesis was significantly better than, administering granisetron alone (66.7% vs 42.8% respectively) (p<0.001). The combination of granisetron and low-dose dexamethasone is superior to granisetron alone to control acute emetic episodes in patients receiving emetogenic chemotherapy.


Keywords


Nausea; Vomiting; Chemotherapy; Granisetron, Dexamethasone

Full Text:

PDF

References


Millev AD, Monaka S. Mechanism of Vomiting in Due by Serotonin Receptor Agonist in the Cat: Effect of Vagotomy, Splanchnicectomy or Postrema lesions. J Pharmaco Exp Ther. 1992; 260: 509-516.

Komoto T, Ito H, Nagakor. Mechanisms of Cisplatin and m Clorophenil Guanide Induced Emesis in Felrets. Eur J Pharmacal. 1993; 239: 369-376.

O’Brein BJ, Rusthoven J, Rocchi A, et al. Impact of Chemotherapy Associated Nausea and Vomiting on Patients Functional Status and on Costs, Survey of Five Canadian Center. UK. 1993: 149. 296-302.

Andrews PL. The Pharmacologic Profile of Granisetron (Kytril). Semin Oncol, 1994, 21: 3-9.

Perez EA, Gardara DR. The Clinical Role of Granisetron in the Prevention of Chemotherapy induced Emesis. Semin Oncol. 1994; 21: 15-21.

Heron JF, Coedhals I, Jordan JP, et al. Oral Granisetron Alone and in Combination with Dexamethazon: Double– Blind- Randomized Comparison Metoclopramid plus Dexamethason in Prevention of Cisplatin– Induced Emesis. Ann Oncol 1994; 5: 579-584.

Latrelle J, Stewart D, Laberg F, et al. Dexamethason Improves the Efficacy of Granisetron in the First 24 hours Following High Dose Cisplatin Chemotherapy. Support Care Cancer 1995; 3: 307-312.

Van Bell SJ, Cocyuyt VF, Bleibery H, etal. Combination Therapy with Novoban in Patients with Incomplete Control of Chemotherapy– Induced Nausea and Vomiting . Anti- Cancer Drug. 1995; 6: 22-30.

Chuang –Chi L, Ceng-Hsu W, Hsien –Kun C, et al. Prevention of Acute and Delayed Cisplatin Induced Nausea and Vomiting with IV Ondansetron plus IV Dexamethasone. Chang Gung Med J. 2000; 23: 413-9.

Parry H, Martin K. Single Dose IV Dexamethasone an Effective Anti-Emetic in Cancer Chemotherapy.Cancer Chemotherapy & Pharmacology. 1991; 28(3): 231-2.

Aapro MS, Thuerlimann B, Sessa C, et al. A Randomized Double–Blind Trial to Compare the Clinical Efficacy of Granisetron with Metoclopramide, both Combind with Dexamethasone in the Prophylaxis of Chemotherapy–Induced Delayed Emesis. Annals of Oncology. 2003; 14: 291-297.

Hesketh PJ, Crews R, Cohene R, et al. Antiemetic Efficacy of Single–Dose Oral Granisetron (1mg, 2mg) with Moderately Emetogenic Chemotherapy. Cancer J Sci Am, 2000; 6: 157-166.

By the Italian Group for Antiemetic Research. Double– Blined, Dose–Finding Study of Four IV Dose of Dexamethasone in the Prevention of Cisplatin-Induced Acute Emesis. Italian Group for Antiemetic Research. J Clin Oncol. 1998; 16: 2937-2942.

Kris MG, Crall RJ, Tyson LB ,et al. Controlling Delayed Vomiting Double–Blind, Randomized Trial Comparing Placebo. Dexamethasone Alone and Metoclopramid plus Dexamethasone in Patients Receiving Cisplatin. J Clin Oncol, 1989; 7: 108-114.

Tsukada H, Hirose T, Yokoyama A, et al. Randomised Comparison of Ondansetron plus Dexamethasone with Dexamethasone Alone for Control of Delayed Cisplatin- Induced Emesis. European Journal of Cancer, 2001. 37: 2398- 2404.

Smith DB, Newlands ES, Rustin GJ, et al. Comparison of Ondansetron and Ondansetron plus Dexamethasonen as Antiemetic Prophylaxis During Cisplatin-Containing Chemotherapy. Lancet, 1991. 338 (8765): 487-90.

Alvarez O, Freeman A, Bedros A, etal. Randomized Double-Blind Crossover Ondansetron-Dexamethasone versus Ondansetron-Placebo Study for the Treatment of Chemotherapy-Induced Nausea and Vomiting in Pediatric Patients with Malignancies. Journal of pediatric hematology/oncology, 1995. 17(2): 145-500.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.