Single high-dose dexamethasone improves the effect of ondansetron on acute chemotherapy-induced nausea and vomiting but impairs the control of delayed symptoms

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
C PetersonG Steineck

Abstract

The introduction of serotonin receptor (5-HT3) antagonists has improved the control of acute nausea and vomiting induced by cancer chemotherapy, but they seem to have little or no effect on delayed symptoms. Corticosteroids are known to reduce both acute and delayed nausea and vomiting. The aim of the present study was to test the hypothesis that a single high dose of dexamethasone (20 mg), a long-acting corticosteroid, given after cisplatin and in addition to ondansetron (8 mg three times a day), would enhance the control of both acute and delayed nausea and vomiting. A group of 104 chemotherapy-naive ovarian cancer patients, scheduled for at least three cycles of combination chemotherapy including cisplatin (50 mg/m2), were randomly allocated to receive either dexamethasone or placebo in addition to ondansetron. Two-thirds of the patients received doxorubin and melphalan on the day before cisplatin and 1/3 received doxorubicin immediately before cisplatin. Unexpectedly we found, in all three chemotherapy cycles, that patients receiving dexamethasone suffered from more delayed nausea and vomiting than patients receiving placebo. In patients with no acute nausea or vomiting, the boomerang effect of dexamethasone could be seen o...Continue Reading

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Citations

Feb 10, 2004·Cancer Treatment Reviews·M P DecatrisK J O'Byrne
Nov 30, 2002·Journal of Pain and Symptom Management·Sussanne BörjesonGunnar Steineck
Aug 17, 1999·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·A A FauserR J Gralla
Jan 26, 2005·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Yuriko SugawaraYosuke Uchitomi
Nov 1, 2016·International Journal of Clinical Pharmacy·Nibal AbunahlahMustafa Kerem Özyavuz
Mar 24, 2005·Psychosomatic Medicine·Sibylle KlosterhalfenPaul Enck
Oct 3, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J P IoannidisJ Lau
Feb 24, 2001·Gastroenterology·E M QuigleyH P Parkman

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