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 multicentre, double-blind, randomised trial comparing ondansetron versus ondansetron plus dexamethasone in the prophylaxis of cisplatin-induced delayed emesis.
The aim was to compare the efficacy of ondansetron and a combination of ondansetron plus dexamethasone in the prophylaxis of cisplatin-induced delayed emesis over three consecutive courses of chemotherapy . Cancer patients scheduled to receive for the first time cisplatin ( > 50 mg/m(2 ) ) in combination with other cytotoxic agents , were recruited in a multicentre , r and omised , double-blind study and treated with ondansetron 8 mg i.v . and dexamethasone 20 mg i.v . Twenty-four hours after the start of chemotherapy , patients were r and omised to treatment either with oral ondansetron 8 mg bd plus placebo on days 2 - 5 ( group A ) or with oral ondansetron 8 mg bd plus oral dexamethasone 8 mg bd on days 2 - 3 , and 4 mg bd on days 4 and 5 ( group B ) . Two hundred and thirty-six cancer patients were recruited into the study . Complete protection from delayed vomiting/nausea in group A and group B was Obtained in 50/39 % and in 63/42 % of patients , respectively in the first course ; in 55/34 % and in 64/40 % in the second and in 49/31 % and 60/37 % in the third . Logistic regression analysis reveals a statistically significant difference in incidence of emesis between the combination of ondansetron plus dexamethasone and ondansetron alone ( P<0.05 ) . The same model , however , shows no difference in incidence of nausea between the two treatment regimens . Ondansetron plus dexamethasone reduces the risk of delayed emesis following cisplatin chemotherapy as compared to ondansetron alone
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 .