Background: Chemotherapy-induced nausea and vomiting (CINV) is a common problem during cancer treatment and its proper management is essential. The primary objective of this study was to compare the efficacy of a single dose palonosetron in the control of chemotherapy-induced nausea and vomiting (CINV) to that of oral aprepitant and ondansetron. The secondary objective is to determine age, gender, morning sickness, motion sickness, as well as chemotherapy protocols as risk factors in increasing chemotherapy-induced nausea and vomiting (CINV). Methods: This is a prospective cohort study carried out at Al-Andalus Private Hospital for Cancer Patients in Baghdad, Iraq. The study included 296 patients, diagnosed with cancer, and receiving high emetogenic chemotherapy protocol. Patients were divided into 3 arms according to the antiemetic received. Arm 1 received aprepitant and ondansetron, arm 2 received ondansetron, and arm 3 received palonosetron. The primary endpoint was the response rate defined as the percentage of patients without nausea or vomiting episodes during the chemotherapy treatment cycles. Other secondary endpoints such as age, gender, morning sickness, motion sickness, as well as chemotherapy protocols, were measured as risk factors in increasing chemotherapy-induced nausea and vomiting (CINV). Results: A total of 296 patients, diagnosed with cancer, and receiving high emetogenic chemotherapy protocol were evaluated. There was no significant association between age or gender and CINV. The incidence of nausea and vomiting with ondansetron was more than the incidence of nausea and vomiting with aprepitant, and the incidence of nausea and vomiting with palonosetron was less than the incidence of nausea and vomiting with aprepitant. There was no significant association between morning sickness and nausea or vomiting. On the other hand, there was a significant association between motion sickness and nausea or vomiting. The most common cycle reported in nausea and vomiting was cycle 3. Regarding suffering from nausea and vomiting with some chemotherapy drugs, the most common drugs were adriamycin cyclophosphamide (AC) and carboplatin. Conclusion: The results of the present study confirm the previous reports on the superiority of palonosetron over ondansetron and its aprepitant in reducing the incidence of CINV. Regarding risk factors, motion sickness, chemotherapy cycle 3, as well as adriamycin cyclophosphamide (AC) and carboplatin were risk factors inducing CINV in high emetogenic chemotherapy protocols.
Background:The main side effects of Tamoxifen are menopausal symptoms. We report a case of leucopenia induced by Tamoxifen in a 28-year-old woman treated in the adjuvant setting. Case Presentation: A 28-year-old woman was diagnosed with invasive ductal carcinoma of the left breast. The final tumor stage was T2, N3, M0, Stage IIIc. She received adjuvant chemotherapy with four cycles of Adriamycin and Cyclophosphamide every three weeks, followed by four cycles of Taxol every three weeks. After chemotherapy, she received the standard dose of adjuvant radiotherapy (50 Gy/15 fractions) for three weeks. Then she received tamoxifen and goserelin treatment for two years. Zoladex was discontinued, and she received tamoxifen only for five months. Blood examination during tamoxifen treatment demonstrated the patient had anemia (hemoglobin: 9.5 g/dL), leucopenia (white blood cells (WBC): 2.2×10 9 /L), neutropenia (granulocytes: 0.9×10 9 /L) and no thrombocytopenia (platelets: 222×10 9 /L). Antinuclear antibodies (ANA) test, anti-double stranded DNA antibody test, erythrocyte sedimentation rate, or C -Reactive Protein (CRP) didn't suggest connective tissue disorder. Moreover, bone marrow aspirate and biopsy of bilateral iliac crest didn't reveal abnormal findings. Tamoxifen was discontinued for one month, and we found improvement of leucopenia (WBC: 3.24×10 9 /L). However, leucopenia recurred to the severer degree after resume of tamoxifen treatment (WBC: 2.6×10 9 /L). These findings suggested that tamoxifen was responsible for leucopenia in this patient. Conclusion: Leucopenia is a rare and important adverse event of tamoxifen, which can cause treatment interruption.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.