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KMID : 0869620170340020172
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Journal of Korean Society of Hospital Pharmacists
2017 Volume.34 No. 2 p.172 ~ p.182
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Palonosetron versus Ondansetron for the Prevention of Chemotherapy induced Nausea and Vomiting in Children and Adolescents
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Rim Eun-Jung
Ree Yoon-Sun
Kim Jae-Song
Son Eun-Sun
Lyu Chuhl-Joo
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Abstract
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Background : In 2015, 0.02 mg/kg (max. 1.5 mg) dose of palonosetron was approved for the prevention of chemotherapy-induced nausea and vomiting in children. In Severance hospital, clinicians used a lower dose of palonosetron than approved for most pediatric patients, because of the safety concerns. Herein, we compared the efficacy and safety of palonosetron with ondansetron for the prevention of chemotherapy-induced nausea and vomiting in children.
Methods : From January 1st 2015 to December 31th 2015, we retrospectively reviewed the electronic medical records of pediatric patients whose chemotherapy were moderately or highly emetogenic and no longer than 4 days. We compared the complete response (CR) rate, no vomiting rate, and no rescue medication rate of the palonosetron and ondansetron groups; and between the 0.02 mg/kg palonosetron and ondansetron groups.
Results : Total cycle number of the palonosetron group was 147, and of the ondansetron group, 190. CR rate of the palonosetron group (42%) was significantly lower than that of the ondansetron group (57%) (p 0.05); whereas, the 0.02 mg/kg palonosetron group showed 46 cycles and no significant difference in the CR rate (46%) (p=0171) compared with the ondansetron group. The palonosetron group and 0.02 mg/kg palonosetron group had a higher proportion of highly emetogenic chemotherapy, and longer regimen days, as compared to the ondansetron group, with significance (p 0.05).
Conclusion : In this study, the CR rate of the palonosetron group was lower than that of the ondansetron group. Treatment with 0.02 mg/kg palonosetron resulted in a high antiemetic effect without complication. This study has limitations, which include its retrospective design and differences in patients’baseline characteristics. Further study is needed to address these issues.
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KEYWORD
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Chemotherapy-induced nausea and vomiting, CINV, Palonosetron, Ondansetron, Children
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