PREVENTION OF CHEMOTHERAPY-INDUCED EMESIS WITH GRANISETRON IN CHILDREN WITH MALIGNANT DISEASES

Purpose: In a prospective crossover study, we evaluated the safety and antiemetic activity of granisetron, a 5-hydroxytryptamine3 (5-HT3) re ceptor antagonist, compared with conventional antiemetics regimen, inc luding metoclopramide, in pediatric cancer patients. Patients and Meth ods: Twenty-two children with malignant diseases were enrolled. The ch emotherapy included cytarabine 3 g/m2 (regimen A), cisplatin 90 mg/m2 (regimen B), and actinomycin D 900 mug/m2 plus ifosfamide 3 g/m2 (regi men C). Granisetron 40 mug/kg was infused over 30 min just before each chemotherapy treatment. Results: A complete response was obtained mor e often with granisetron than with conventional antiemetics (59.1% vs. 0%, p < 0.001). In terms of efficacy by chemotherapy type, complete r esponse with granisetron was obtained in eight of 10 patients with reg imen A, three of eight with regimen B, and two of four with regimen C. Major efficacy (vomiting fewer than two times) was also obtained more with granisetron than with conventional antiemetics (81.8% vs. 4.6%, p < 0.001). The number of vomiting episodes in the first 24 h was less with granisetron than with conventional antiemetics (1.1 +/- 1.46 vs. 9.0 +/- 4.97, p < 0.001). Normal appetite and activity were retained in more patients with granisetron than with conventional antiemetics. Extrapyramidal reactions, akathisia, and sedation were not seen in any case with granisetron. Conclusions: Granisetron 40 mug/kg is well tol erated and more effective than are conventional antiemetic regimens co ntaining metoclopramide for children receiving cancer chemotherapy.