PREVENTION OF CISPLATINUM-INDUCED DELAYED EMESIS AND NAUSEA

Background: Since the introduction of 5-HT3 antagonists, delayed and a nticipatory emesis becomes more apparent. It is unclear whether delaye d emesis may be better controlled by continued treatment with 5-HT3 an tagonists or by a change of medication to benzamides. Patients and Met hod: 70 patients with histologically proven ovarian carcinoma under-go ing their first PEC chemotherapy (cisplatinum, epirubicin, cyclophosph amide) received 8 mg of ondansetron intravenously on the day of chemot herapy. On the next day, randomly half of the patients received ondans etron orally (2 x 8 mg), the other half received alizapride (3 x 100 m g) for the next 3 days. well-being was investigated with the 'Giessene r Beschwerdebogen' (questionnaire of complaints), combined with object ive data on emesis, nausea, and bowel movement. Results; Significant d ifferences (U test by Mann and Whitney; Kruskal-Wallis analysis) betwe en both groups with respect to the degree of complaint were detected b etween the items headache, retching and loss of appetite in favour of the group receiving alizapride. A positive trend with respect to tired ness, dislike of certain food, loss of appetite, weakness, palpitation s of the heart, sensations of repletion, emesis, nausea, and heartburn was detected in the group receiving alizapride. Conclusion: While 5-H T3 antagonists are superior with respect to acute emesis, benzamides s eem to be more efficient in the treatment of delayed emesis and are al so less expensive in highly emetogenic cancer chemotherapy and highly emetogenic risk groups.