EFFECT OF 5-HT3 ANTAGONIST WITH CORTICOSTEROID IN THE TREATMENT OF CHEMOTHERAPY INDUCED NAUSEA AND VOMITING

Abstract

Background: Chemotherapy-induced nausea and vomiting (CINV) are major adverse effects of cancer chemotherapy. Inadequate control CINV can have a significant negative impact on quality of life and can compromise adherence to chemotherapy treatment. The aim of this prospective clinical trial was to evaluate the antiemetic effect of ondansetrone combined with dcexamethasone against CINV produced by high and moderate emetogenic chemotherapy in Iraqi patients.

Patients and Methods: A prospective clinical trial was conducted .Patients completed 5-day daily diaries beginning on the day of single-day chemotherapy and for one to three chemotherapy cycles, the symptoms diary was designed to collect data regarding patient's demographic characteristics, cancer type, chemotherapy regimen to patient receive ondansetrone combined with dexamethasone for the treatment of CINV.

Results: A total of 52 patients were enrolled in this study, with age range of 18-63 year (41.4±17.3; Mean ±SD) of both sexes (57.7% male and 42.3% female), 65.38 % of the patients classified as receiving high emetogenic chemotherapy, whereas 34.61% of the patients receiving moderate emetogenic chemotherapy. All the patients received ondansetrone combined with dcexamethasone for the treatment of CINV, the incidence of acute nausea in patients receiving high emetogenic chemotherapy (HEC) was 41.17% compared to 22.22% in patients receiving moderate emetogenic chemotherapy (MEC); The incidence percent of delayed nausea was 35.29% in patients receiving HEC compared to 22.22% in patients receiving MEC; the effect of administered antiemetics on the incidence of acute vomiting was 35.29% in patients receiving HEC compared to 22.22% in patients receiving MEC; unexpectedly, the incidence of delayed vomiting was only 11.76% in patients receiving HEC compared to 22.22% in patients receiving MEC.

Conclusion: the results of this study demonstrate that administration of Ondansetrone combined with dexamethasone regimen against CINV produced accepted antiemtic level compared to data reported internationally; this study highlights the need for efficient translation of standard guidelines of antiemetic to clinical practice.

 Key word: Antiemetic, chemotherapy, nausea, vomiting, ondansetrone, dexamethasone.