Cisplatin is an highly effective agent against a variety of cancers but produces the most severe nausea and vomiting compared with other chemotherapeutic agents. Recently the role of 5-HT3(serotonin) in cisplatin induced nausea and vomiting was
introduced and serotonin receptor antagonists seem to be as effective as corticosteroids in preventing ciplatin-induced emesis.
From October 1994 to August 1995, we evaluate antiemetic effect of granisetron, a selective 5-HT3 receptor antagonist, in 20 patients (M:F=11:9) who receiving their first courseof combination chemotherapy containing high dose cisplatin(100mg/m2).
Granisetron 3mg was given intravenous infusion before 100mg/m* of cisplatin infusion.
In first 24 hours after chemotherapy, complete response achieved in 18 of 20 patients(90%). First episode of vomiting developed at 31.5*20.3 hours after cisplatin infusion. For delayed emesis, on second day, complete response achieved in 11 of 18
patients (61%), major response in 4 of 18 patients (22%), minor response in 3 patients (17%) and from third to seventh day, complete response achieved in 8 of 18 patients (44%), major response in 7 of 18 patients (39%), minor response in 3
patients
(17%). Most commonly reported adverse effect of granisetron was headache.
In conclusion, granisetron was an effective antiemetic agent in preventing cisplatin-in-duced acute emesis but not so effective in delayed emesis. For better control of delayed emesis, new combination antiemetic therapy should be investigated.
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