Tetrahydrocannabinol vs. prochlorperazine. The effects of two antiemetics on patients undergoing radiotherapy.

Ungerleider, J. Thomas; Andrysiak, Therese; Fairbanks, Lynn A.; Tesler, A S; Parker, R G

doi:10.1148/radiology.150.2.6318262

Cited by 29 publications

(11 citation statements)

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“…These provided the basis for the new proposed guidelines discussed by the experts and described below. There are three RCTs in patients with fractionated radiotherapy [24,29,39] and one with single-fraction radiotherapy [18] investigating the efficacy of non-5-HT 3 antagonists in radiotherapy of the upper abdomen. There was no difference among the various compounds used, and the antiemetic efficacy was limited.…”

Section: Discussionmentioning

confidence: 99%

“…In the first study, 39 patients were randomised to receive oral metoclopramide or nabilone. In the second, 89 patients were treated with oral metoclopramide, prochlorperazine or placebo, and in the third, 11 patients received tetrahydrocannabinol or prochlorperazine [24,29,39]. Only one randomised study has been carried out with 43 patients submitted to single-fraction palliative radiotherapy to the thoracic and/or lumbar spine.…”

Section: Randomised Clinical Trialsmentioning

confidence: 99%

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Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines

Feyer

Maranzano

Molassiotis

et al. 2004

Support Care Cancer

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As many as 40-80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting, depending on the site of irradiation. Fractionated RT may involve up to 40 fractions over a 6-8 weeks period, and prolonged symptoms of nausea and vomiting could affect quality of life. Furthermore, uncontrolled nausea and vomiting may result in patients delaying or refusing further radiotherapy. Nausea and vomiting are often underestimated by radiation oncologists. Incidence and severity of nausea and vomiting depend on RT-related factors (single and total dose, fractionation, irradiated volume, radiotherapy techniques) and patient-related factors (gender, general health of the patient, age, concurrent or recent chemotherapy, psychological state, tumor stage). Current antiemetic guidelines prescribe the emetogenicity of radiotherapy regimens and recommend the use of 5-HT(3) antagonists with or without a steroid for prophylaxis in moderately and highly emetogenic treatment (MASCC, ASCO, ASHP, NCCN). The new proposed guidelines summarise the updated data from the literature and take into consideration the existing guidelines. According to the irradiated area (the most frequently studied risk factor), the proposed guidelines are divided into four levels of emetogenic risk: high, moderate, low and minimal. They offer guidance to prescribing physicians for effective antiemetic therapies in RINV.

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Section: Discussionmentioning

confidence: 99%

Section: Randomised Clinical Trialsmentioning

confidence: 99%

Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines

Feyer

Maranzano

Molassiotis

et al. 2004

Support Care Cancer

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“…In cancer patients, administration of oral Δ 9 -THC has been shown to significantly suppress the experience of nausea and vomiting, in comparison to placebo controls (Chang et al, 1979; Frytak et al, 1979; Orr et al, 1980; Sallan et al, 1975; Sweet et al, 1981) and when compared to the D 2 receptor antagonists available at the time, Δ 9 -THC was at least as effective (Carey et al, 1983; Crawford and Buckman, 1986; Cunningham et al, 1988; Frytak et al, 1979; Tramèr et al, 2001; Ungerleider et al, 1984) if not more effective (Ekert et al, 1979; Orr and McKernan, 1981) at reducing nausea and vomiting. Clinical evidence suggests that Δ 8 -THC suppresses anticipatory nausea in child patients (Abrahamov et al, 1995).…”

Section: Cannabinoids and Endocannabinoids In The Control Of Nausementioning

confidence: 99%

Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system

Sharkey

Darmani

Parker

2014

European Journal of Pharmacology

172

136

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Nausea and vomiting (emesis) are important elements in defensive or protective responses that animals use to avoid ingestion or digestion of potentially harmful substances. However, these neurally-mediated responses are at times manifested as symptoms of disease and they are frequently observed as side-effects of a variety of medications, notably those used to treat cancer. Cannabis has long been known to limit or prevent nausea and vomiting from a variety of causes. This has led to extensive investigations that have revealed an important role for cannabinoids and their receptors in the regulation of nausea and emesis. With the discovery of the endocannabinoid system, novel ways to regulate both nausea and vomiting have been discovered that involve the production of endogenous cannabinoids acting centrally. Here we review recent progress in understanding the regulation of nausea and vomiting by cannabinoids and the endocannabinoid system, and we discuss the potential to utilize the endocannabinoid system in the treatment of these frequently debilitating conditions.

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“…In the first study, 39 patients were randomized to receive oral metoclopramide or nabilone. In the second, 89 patients were treated with oral metoclopramide, prochlorperazine or placebo, and in the third, 11 patients received tetrahydrocannabinol or prochlorperazine [7,9,35,44]. Only one randomized study has been carried out with 43 patients submitted to single-fraction palliative radiotherapy to the thoracic and/or lumbar spine.…”

Section: Prophylaxis With Non-5-ht 3 Receptor Antagonistsmentioning

confidence: 99%

Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009

Feyer

Maranzano

Molassiotis

et al. 2010

Support Care Cancer

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Radiation-induced nausea and vomiting (RINV) are still often underestimated by radiation oncologists. However, as many as 50-80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting, depending on the site of irradiation. Fractionated RT may involve up to 40 fractions over a 6-8-week period, and prolonged symptoms of nausea and vomiting affect quality of life. Furthermore, uncontrolled nausea and vomiting may result in patients delaying or refusing further radiotherapy. Incidence and severity of nausea and vomiting depend on RT-related factors (irradiated site, single and total dose, fractionation, irradiated volume, radiotherapy techniques) and patient-related factors (gender, general health of the patient, age, concurrent or recent chemotherapy, psychological state, tumor stage). The new proposed guideline from the Multinational Association of Supportive Care in Cancer and European Society of Clinical Oncology summarises the updated data from the literature and takes into consideration the existing guidelines. According to the irradiated area (the most frequently studied risk factor), the proposed guideline divided these areas into four levels of emetogenic risk: high, moderate, low and minimal. In fact, the emetogenicity of radiotherapy regimens and recommendations for the appropriate use of antiemetics including 5-hydroxytryptamine receptor antagonists and steroids are given in regard to the applied radiotherapy or radiochemotherapy regimen. This updated guideline offers guidance to the treating physicians for effective antiemetic therapies in RINV.

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Tetrahydrocannabinol vs. prochlorperazine. The effects of two antiemetics on patients undergoing radiotherapy.

Cited by 29 publications

References 0 publications

Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines

Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines

Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system

Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009

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