COMPARISON OF ONDANSENTRON VERSUS ONDANSENTRON PLUS METHYLPREDNISOLONE AS ANTIEMETIC PROPHYLAXIS DURING CISPLATIN-CONTAINING CHEMOTHERAPY

We compared the antiemetic efficacy of ondansentron versus ondansentro n and corticosteroids in cisplatin-induced emesis. None of our patient s had received prior chemotherapy. All patients received chemotherapy including cisplatin 100 mg/m(2). Forty patients received ondansentron alone (Group A) and 40 the combination of ondansentron and methylpredn isolone;solone (Group B). Ondansentron was given at a dose of 8 mg in 100 mt N/S over 10 min by intravenous infusion. The initial dose was a dministered before the cisplatin and was followed by 8 mg wally in the afternoon and before sleeping the first day of chemotherapy. During t he next 2 days, the patients received 8 mg orally 3 times daily. Methy lprednisolone was given as an intravenous bolus of 40 mg before chemot herapy and then together with each dose of ondansentron at a dose of 1 6 mg orally. Group A had significantly longer duration of nausea after chemotherapy than group B (117 +/- 111 min, 62 +/- 71 min, P < 0.013) . The response on emesis was also improved in group B, especially the day of chemotherapy [treatment failure: group A: 13 patients (30%) ver sus group B: 5 patients (11.6%), P < 0.03] and the next day [complete response: group A: 17 patients (39.5%) versus group B: 30 patients (63 .7%), P < 0.005]. Patients in group B presented more sedative effects (P < 0.001) and better appetite (P < 0.02) than patients in group A. T here were no other significant differences in side effects (activity, headache, constipation, etc). We conclude that corticosteroids improve the antiemetic efficacy of ondansentron in cisplatin-induced chemothe rapy, and should be included in antiemetic regimens.