Issues in antiemetic therapy

Goldspiel, Barry R.; Curt, Gregory A.

doi:10.1002/(sici)1097-0142(19960301)77:5<823::aid-cncr3>3.0.co;2-f

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…Our findings are consistent with the progress that has been made in reducing certain chemotherapy‐associated toxicities. The appearance of 5‐hydroxytryptamine receptor antagonists during the 1990s significantly reduced the incidence of chemotherapy‐induced emesis 9–12. The fear of needles has been eliminated (that card was not chosen by any patient in our study) by the introduction of implantable ports and the use of topical anesthesia (EMLA [Aminoamide], Astra Zeneca Pharmaceuticals, Westborough, MA) before venipuncture.…”

Section: Discussionmentioning

confidence: 94%

Changing patient perceptions of the side effects of cancer chemotherapy

Carelle¹,

Piotto²,

Bellanger³

et al. 2002

Cancer

404

227

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BACKGROUND Quality‐of‐life (QoL) issues have become increasingly important as the number of newly diagnosed patients with cancer increases and survival improves. In 1983, Coates et al. reported a survey of patient perceptions of the side effects of cancer chemotherapy and showed the importance of including patient feedback for the accurate assessment of QoL (Eur J Cancer Clin Oncol. 1983;19:203–208.). The authors carried out a similar survey in 100 patients with cancer with the objectives of 1) investigating the changes in patient perceptions that have occurred and 2) evaluating the impact of new treatments on the profile of chemotherapy side effects among patients receiving anticancer drugs. METHODS One hundred patients attending the outpatient Medical Oncology Department of the Pitié Salpêtrière Hospital Group were surveyed between August 1998 and February 2000 by trained interviewers who were blinded to the patients' treatment. Patients identified all side effects associated with their treatment using a set of 45 cards that named physical side effects (Group A) and a set of 27 cards that named nonphysical side effects (Group B), and the patients ranked these side effects according to severity. The top 5 cards from each group were then combined, and the resulting 10 cards were rated again by severity, regardless of group. Results were analyzed for the entire cohort and for demographic, social, and clinical subgroups. RESULTS The participants included 65 women and 35 men; the most common malignancies were breast carcinoma (40 patients), gastrointestinal carcinoma (19 patients), lung carcinoma (7 patients), and ovarian carcinoma (9 patients). Patients rated affects my family or partner as the most severe side effect, alopecia was second, and fatigue was the third most severe. Effects on work or home responsibilities, effects on social activities, and loss of interest in sex were ranked fourth, fifth, and sixth, respectively. The results contrasted with those of Coates et al., in which affects my family or partner was ranked 10th, and fatigue was ranked 8th. CONCLUSIONS Patient perceptions of the side effects of cancer chemotherapy have changed markedly. In the current study, fatigue and psychosocial QoL concerns predominated, compared with emesis, nausea, and negative reactions to the treatment visit in the original survey. The current findings are consistent with the progress that has been made in reducing certain chemotherapy‐associated toxicities. Fatigue, however, although it often is related to anemia and is treatable with recombinant human erythropoietin, remains a major concern. The emotional, social, and sexual consequences of cancer treatment present continuing challenges in efforts to optimize QoL and to develop effective supportive care. Cancer 2002;95:155–63. © 2002 American Cancer Society. DOI 10.1002/cncr.10630

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Section: Discussionmentioning

confidence: 94%

Changing patient perceptions of the side effects of cancer chemotherapy

Carelle¹,

Piotto²,

Bellanger³

et al. 2002

Cancer

404

227

View full text Add to dashboard Cite

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Comparison of Tropisetron and Granisetron in the Control of Nausea and Vomiting in Children Receiving Combined Cancer Chemotherapy

Aksoylar¹,

Akman²,

Özgenç³

et al. 2001

Pediatric Hematology and Oncology

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Tropisetron and granisetron are selective serotonin (5-HT3) antagonists that have been proven effective in the prevention of nausea and vomiting in adults and children receiving cancer chemotherapy. This prospective, randomised study was designed to compare the efficacy of the two agents in the prevention of vomiting and nausea in children receiving highly emetogenic chemotherapy for various malignancies. A total of 51 children (mean age: 7.7 +/- 4.8 year) were studied in 133 chemotherapy cycles. In 66 chemotherapy cycles, the children received tropisetron as an antiemetic agent in a dose of 0.2 mg/kg/24 h intravenously and, in 67 cycles, they received granisetron 40 micrograms/kg/24 h intravenously before cytotoxic drug administration during the days they received chemotherapy. The response per 24 h of chemotherapy was defined as complete (no nausea and vomiting), partial (1-4 events of vomiting and/or nausea), and failure (more than 4 events of vomiting and/or nausea). Efficacy of antiemetic therapy was evaluated as acute (Day 1) and overall was based on the worst day during the chemotherapy. Complete control of acute vomiting was achieved in 74% of tropisetron and 88% of granisetron patients (P = 0.04), and complete control of acute nausea in 56% and 82% respectively (p = 0.002). Overall response by means of complete control of both vomiting and nausea during the whole therapy period was 29% of tropisetron group and 55% of granisetron group (p = 0.007). The statistical analysis (depending on the emetogenicity of the chemotherapy cycles) showed increased efficacy of granisetron in highly (grade 3) emetogenic chemotherapy cycles (p = 0.002), whereas there was no difference in the very highly emetogenic cycles (p = 0.7). Also, granisetron was found to be more effective than tropisetron, especially in patients heavier than 25 kg (p = 0.02). The adverse reactions were few and mild. There were no differences in the tolerability of the two antiemetic therapy modalities. In conclusion, granisetron was found to be more effective than tropisetron in controlling nausea and vomiting in children receiving highly emetogenic chemotherapy. This increased antiemetic efficacy of ganisetron might have been related to maximal dose differences according to body weight.

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Ondansetron and Tropisetron in the Control of Nausea and Vomiting in Children Receiving Combined Cancer Chemotherapy

Stiakaki

Savvas²,

Lydaki³

et al. 1999

Pediatric Hematology and Oncology

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Ondansetron (Zofron, Glaxo) and tropisetron (Navoban, Sandoz) are selective serotonin (5HT3) antagonists that have proven very effective in the prevention of vomiting and nausea in adults and children receiving cancer chemotherapy. This study compared the efficacy of the two agents in the prevention of vomiting and nausea in children receiving chemotherapy for solid tumors and blood malignancies. A total of 23 children were studied in 205 chemotherapeutic cycles (116 one-day regimens and 89 multiple-day regimens). In 102 chemotherapeutic cycles the children received ondansetron as an antiemetic agent in a dose of 5 mg/m2 30 min before chemotherapy was given and then 4 mg/m2 every 8 h i.v. (group A) and in 103 cycles they received tropisetron in one dose of 0.2 mg/kg 24 h-1 i.v. (max dose 5 mg) 30 min before cytotoxic drugs administration every day they received chemotherapy (group B). The response was defined as complete in the absence of nausea and vomiting per 24 h of chemotherapy, as partial given the presence of 1-4 events of vomiting and/or nausea less than 5 h per 24 h, and as failure if there were more than 4 events of vomiting and/or nausea for more than 5 h per 24 h of chemotherapy. The response of the two groups was studied independently and depending on the degree of emetogenicity of the chemotherapeutic agents, which were divided into mildly, moderately, and highly emetogenic. The comparison of the two groups not taking into consideration the emetogenicity of the chemotherapeutic agents showed that ondansetron was more effective in 1-day regimens (P = .023), whereas the two agents were equally effective in multiple-day regimens (P = .2). The statistical analysis depending on the emetogenicity of the chemotherapeutic agents showed increased efficacy of ondansetron in mild (P = .017) and moderately emetogenic chemotherapeutic agents, whereas there was no difference in the highly emetogenic drug group. Ondansetron is found to be more effective than tropisetron in controlling acute nausea and vomiting in children receiving mild and moderately emetogenic chemotherapeutic drugs, although there is no difference in the efficacy of both antiemetic agents when highly emetogenic drugs are administered.

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Issues in antiemetic therapy

Cited by 4 publications

References 16 publications

Changing patient perceptions of the side effects of cancer chemotherapy

Changing patient perceptions of the side effects of cancer chemotherapy

Comparison of Tropisetron and Granisetron in the Control of Nausea and Vomiting in Children Receiving Combined Cancer Chemotherapy

Ondansetron and Tropisetron in the Control of Nausea and Vomiting in Children Receiving Combined Cancer Chemotherapy

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