Nausea and vomiting are common and the most distressing side effects of cancer chemotherapy. As these symtoms can cause emotional instability and malnutrion from poor oral intake, which further lead to decrease the effect of chemotherapy, it is
important to prevent emesis adquately and effectively. Ondansetron is a selective 5-HT3 receptor antagonist and is reported to be effective in preventing cisplatin-induced emesis. Gramsetron is a potent and the most selective 5-HT3 receptor
antagonist
currently available. We conducted a prospective, randomized, open, single center, parallel group study to compare the antiemetic effect and safety of granisetron versus ondansetron in patients receiving moderately emetogenic chemotherapy. From
December
1994 to May 1995, 65 consective patients who planned to received moderately emetogenic chemotherapy(80 to 100mg/m* of cisplatin or 40mg/m* of doxorubicin) were enrolled in this study. Granisetron was administered intravenously prior to
chemotherapy
at a
dose of 3mg, and up to two doses of granisetron could be administered as rescue therapy within the first 24 hour period. Ondansetron 8mg was given intravenously prior to chemotherapy followed by 2 more doses at 8 and 16 hours after chemotherapy.
Finally, we evaluated 63 patients(32 receiving granisetron and 31 receiving ondansetron). In The first 24 hours after chemotherapy, complete and major response were achieved in 78.1% of patients receiving granisetron and 74.2% of patients
receiving
ondansetron(p=0.7163). There were also no differences in the control of delayed nausea and vomiting between two groups(56.3% vs 45.2%, p=0.3826). There were no differences in percentages of patients who received rescue therapy across the
treatment
groups; 31.5% for granisetron vs. 45.2% for ondansetron during the study(p=0.3803). During the first 24 hours following chemotherapy, these were no differences in time to first episodes of nausea(granisetron 14 hours 20 minutes vs ondansetron 13
hours)
and vomiting(granisetron 20 hours vs ondansetron 19 hours 20 minutes) between two groups. There were no significant adverse effects or toxicities with these antiemetics. We concluded that single dose granisetron was as effective in prophylaxis of
emesis
induced by moderatly emetogenic chemotherapy as triple doses of ondansetron and oral maintainence combination. For the non-responders to granisetron, combination of granisetron with other antiemetics of different action mechanism or maintainence
granisetron trial are warranted.
|