For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .
A prospective randomized double-blind trial comparing ondansetron versus prochlorperazine for the prevention of nausea and vomiting in patients undergoing fractionated radiotherapy.
In a multicentre , international double-blind trial , patients undergoing courses of five or more daily radiotherapy treatments to the upper abdomen were r and omized to receive either oral ondansetron 8 mg t.d.s . or oral prochlorperazine 10 mg t.d.s . throughout their radiation course in order to try to prevent nausea and vomiting . A total of 192 patients were recruited , 135 of whom were included in the efficacy analysis ; of these , 70 received ondansetron and 65 prochlorperazine . Forty-three ( 61 % ) of the patients prescribed ondansetron and 23 ( 35 % ) of those given prochlorperazine had a complete response , with no emetic episodes throughout their treatment course ( P = 0.002 ) . There was , however , no significant difference between the two groups with respect to the incidence and severity of nausea . Seventeen ( 24 % ) of the patients on ondansetron and 19 ( 29 % ) of those given prochlorperazine were treatment failures , experiencing more than five emetic episodes on their worst day during the study . Both drugs were well tolerated , although constipation was seen more commonly with ondansetron
For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .