Comparison of ondansetron and ondansetron plus dexamethasone as antiemetic prophylaxis during cisplatin-containing chemotherapy

Smith, D. B.; Newlands, ES; Rustin, G. J. S.; Begent, R. H. J.; Howells, N.; McQuade, B.; Bagshawe, K. D.

doi:10.1016/0140-6736(91)90555-4

Cited by 208 publications

(68 citation statements)

References 23 publications

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“…However in these two studies corticosteroids were given only on the first day of each course. The present study confirms the major antiemetic efficacy of ondansetron and corticosteroids in combination already mentioned by various authors (Roila et al, 1991;Smith et al, 1991;Soukop et al, 1992) and confirms its activity over three identical chemotherapy courses. Moreover, this combination has shown its superiority over some of the reference antiemetic regimens: metoclopramide, dexamethasone and diphenhydramine (Italian Group for Anti-emetic Research, 1992).…”

Section: Discussionsupporting

confidence: 77%

Methylprednisolone enhances the efficacy of ondansetron in acute and delayed cisplatin-induced emesis over at least three cycles

Chevallier¹,

Marty²,

Paillarse³

1994

Br J Cancer

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Section: Discussionsupporting

confidence: 77%

Methylprednisolone enhances the efficacy of ondansetron in acute and delayed cisplatin-induced emesis over at least three cycles

Chevallier¹,

Marty²,

Paillarse³

1994

Br J Cancer

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“…The effect on nausea is less well researched, being more difficult to evaluate. However, complete control of nausea and emesis is not achieved in every patient (Jones et al, 1991;Smith et al, 1991;Smyth et al, 1991) and it would be worthwhile to examine the prevalence of anticipatory nausea and emesis where a 5HT3 anti-emetic is in use. The low numbers of patients on this type of anti-emetic, in the present study, precluded any detailed examination of these effects.…”

Section: Discussionmentioning

confidence: 99%

Anticipatory nausea and emesis, and psychological morbidity: assessment of prevalence among out-patients on mild to moderate chemotherapy regimens

McCarron¹,

Law²

1992

Br J Cancer

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Summary The prevalence of nausea and emesis among a series of out-patients (n = 95) receiving mainly mildto moderately-emetic cytotoxics, was assessed, along with levels of psychological morbidity. Particular focus was given to the rates of psychologically-based (anticipatory) nausea and emesis. Results indicated that 23% of patients experienced anticipatory nausea and the majority reported that this occurred before at least half of the previous treatment cycles. Both There is also an increasing literature showing that some patients receiving CT develop psychologically-based nausea and emesis (Watson & Marvell, 1991). Although this may occur before, during or after administration of CT most studies examine anticipatory symptoms, as the psychological effect is more difficult to distinguish from purely drug-related effects at other times. However, post-treatment nausea and emesis which is out of proportion to the emetic challenge of the CT drugs may well indicate a psychological element and this effect is less well researched.Although occurring less commonly than post-treatment nausea and emesis, the importance of the anticipatory sideeffect lies in its intractability once established and the fact that it may continue after CT administration has ceased, with some patients feeling nauseous when they return for followup out-patient appointments (Hughson & Cooper, 1988). Furthermore, it is assumed that with the advent of the 5-hydroxytryptamine3 (5-HT3) antagonists, not only will post-treatment side-effects be controlled, but anticipatory symptoms should become a thing of the past. However, control using 5-HT3 drugs is not always complete (Jones et al., 1991;Smyth et al., 1991) and as yet there are no published studies which examine the prevalence of an anticipatory nausea and emesis response where 5HT3, drugs were used, although clearly such studies are needed.The most widely accepted explanation for anticipatory/ psychologically-based nausea and emesis is that it is a conditioned (i.e. learnt) response. Neutral stimuli present at the time of CT administration, and associated with the druginduced effect, acquire the ability to trigger nausea and/or emesis during subsequent treatment cycles, even when the drug has not yet been administered. In psychological terms this is a very simple learning paradigm and the effect has also been observed in sub-humans.A number of studies have drawn attention to the possible role of anxiety as a contributory factor (Altmaier et al., 1982;Andrykowski et al., 1985;Nerenz et al., 1986). It is intuitively appealing to explain psychologically-based nausea and emesis in terms of 'nerves' yet it is clear from Andrykowski's recent review (1990) Other possible risk factors potentiating psychologicallybased nausea and emesis include a tendency to travel sickness in adulthood, and younger age (Morrow et al., 1991). The clearest contributor, however, is thought to be severe and long-lasting nausea and emesis following previous CT infusions. Thus it is likely that the toxicity of the drug re...

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“…Dexamethasone given before chemotherapy has been shown to reduce acute nausea and vomiting (Cassileth et al, 1983;Kris et al, 1989;Smith et al, 1991;Smyth et al, 1991;Roila et al, 1991Roila et al, , 1992Hesketh et al, 1994Hesketh et al, , 1995Adams et al, 1995;Latreille et al, 1995;Lofters et al, 1997;Warr, 1997;Ioannidis et al, 2000). Dexamethasone given after highly emetogenic chemotherapy reduces delayed emesis (1997a, b;Herrstedt et al, 1998;Ioannidis et al, 2000) and is recommended by all the antiemetic guidelines (1997a, b, 1999Gralla et al, 1999Gralla et al, , 2001Koeller et al, 2002).…”

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confidence: 99%

Side effects associated with the use of dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy

et al. 2006

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The role of dexamethasone to reduce delayed emesis following highly emetogenic chemotherapy is proven, but there is less evidence of benefit after mild -moderately emetogenic regimens. Here, we develop and evaluate a Dexamethasone Symptom Questionnaire (DSQ) to assess the side effects of dexamethasone in the week after patients receive moderately emetogenic chemotherapy. The DSQ was first optimised with the aid of a focus group. Sixty patients receiving oral dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy for cancer completed and then evaluated the DSQ. Patients reported that the DSQ was clearly worded and addressed items important to them. Patients receiving dexamethasone reported moderate-severe problems with insomnia (45%), indigestion/epigastric discomfort (27%), agitation (27%), increased appetite (19%), weight gain (16%) and acne (15%) in the week following chemotherapy. The side effects of dexamethasone may outweigh its benefits when used with moderately emetogenic chemotherapy. A randomised, double-blind crossover trial is underway to determine the effect of dexamethasone on nausea and vomiting, and the impact of side effects of dexamethasone and of nausea and vomiting on quality of life.

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Comparison of ondansetron and ondansetron plus dexamethasone as antiemetic prophylaxis during cisplatin-containing chemotherapy

Cited by 208 publications

References 23 publications

Methylprednisolone enhances the efficacy of ondansetron in acute and delayed cisplatin-induced emesis over at least three cycles

Methylprednisolone enhances the efficacy of ondansetron in acute and delayed cisplatin-induced emesis over at least three cycles

Anticipatory nausea and emesis, and psychological morbidity: assessment of prevalence among out-patients on mild to moderate chemotherapy regimens

Side effects associated with the use of dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy

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