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 .
Role of maintenance oral dexamethasone in prophylaxis of delayed emesis caused by moderately emetogenic chemotherapy.
BACKGROUND Although usually a problem of cisplatin-based chemotherapy , delayed emesis can cause severe distress in patients treated with cyclophosphamide . Dexamethasone has been shown to be effective in the control of cisplatin-induced delayed emesis , but its role against the delayed problem in patients treated with cyclophosphamide  has not been demonstrated . Our study was conducted to evaluate the effect of dexamethasone in delayed emesis induced by cyclophosphamide . PATIENTS AND METHODS Ninety-eight patients were given i.v . granisetron and i.v . dexamethasone before chemotherapy , and r and omised to receive either oral dexamethasone 4 mg twice daily as maintenance or no maintenance . RESULTS Ninety-four patients were evaluable . Of those given maintenance oral dexamethasone , 57 % had complete and 30 % had major control of delayed emesis , versus 33 % and 15 % , respectively , of patients who did not receive maintenance . Side effects are mainly constipation and headache . CONCLUSION The results shows that oral dexamethasone is an effective agent against cyclophosphamide-induced delayed emesis
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 .