Cisplatin, an agent highly effective against a variety of cancers, of cancers, produces the most severe nausea and vomiting of any chemotherapeutic agents. Recently, the role of 5-HT3(serotonin) in cisplatin induced nausea and vomiting was
introduced
and ondansetron a selective 5-HT3 receptor antagonist, was administered to prevent cisplatin induced nausea and vomiting. Remarkable effects on acute emesis was obtained but effects on delayed emesis was not controlled by ondansetron only. This
study
was done to investigate the effectiveness and side effects of ondansetron combined with dexamethasone in cisplatin induced nausea and vomiting.
To evaluate the effetiveness of ondansetron combined with dexamethasone in preventing cisplatin induced nause and vomiting, 16 cancer patients who were treated with intravenous cisplatin containing chemotherapy as the first anticancer therapy
were
administered 20 mg dexamethasone i. v. 20minutes before and 8 mg ondansetron i.v. 15 minutes before, 4 hour and 8 hour after ciaplatin infusion respectively on day 1, and 8 mg ondansetron was administered orally three times a day on day 2~4.
On the first day, the complete response and major response were noted in 75%(12/16 patients), and 19%(3/16 patients) respectively, minor response in 6%(1/16 patients), and none showed failure. On the second day, the complete response and major
response
were noted in 44%(7/16 patients) and 25%(4/16 patients) respectively, minor response in 19%(3/16 patients), and 12%(2/16 patients) showed failure. On the third to fourth day, complete response was noted in 29%(4/14 patients), major response
29%(4/14
patients), and minor response and failure were noted in 21%(3/14 patients) respectively. Two patients complained headache, dizziness respectively and the other two patients complained abdominal pain and diarrhea, but the degree was mild and
subsided by
conservative management.
With these results, the administration of ondansetron and dexamethasone to prevent the cisplatin induced nausea and vomiting was effective for acute emesis but not so effective in delayed emesis even with combination of dexamethasone. Further
study
would be necessary to overcome the low effectiveness on the control of delayed emesis.
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