Ondansetron and tropisetron in the control of nausea and vomiting in children receiving combined cancer chemotherapy

Ondansetron (Zofron, Glare) and tropisetron (Navoban, Sandoz) are selective serotonin (5HT(3)) antagonists that have proven very effective in the prev ention of vomiting and nausea in adults and children receiving cancer chemo therapy. This study compared the efficacy of the two agents in the preventi on of vomiting and nausea in children receiving chemotherapy for solid tumo rs and blood malignancies. A total of 23 children were studied in 205 chemo therapeutic cycles (116 one-day regimens and 89 multiple-day regimens). In 102 chemotherapeutic cycles the children received ondansetron as an antieme tic agent in a dose of 5 mg/m(2) 30 min, before chemotherapy was given and then 4 mg/m(2) every 8 h IV (group A) and in 103 cycles they received tropi setron in one dose of 0.2 mg/kg 24 h(-1) IV (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 vomit ing per 24 It of chemotherapy as partial given the presence of 1-4 events o f vomiting and/or nausea less than 5 h per 24 h, and as failure if there we re 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 a nd depending on the degree of emetogenicity of the chemotherapeutic agents, which were divided into mildly; moderately, and highly emetogenic. The com parison of the two groups not taking into consideration the emetogenicity o f the chemotherapeutic agents showed that ondansetron was more effective in I-day regimens (P =.023), whn eas the two agents were equally effective in multiple-day regimens (P =.2). The statistical analysis depending on the e metogenicity of the chemotherapeutic agents showed increased efficacy of on dansetron in mild (P =.017) and moderately emetogenic chematherapeutic agen ts, whereas there was no difference in the highly emetogenic drug group. On dansetron is found to be more effective than tropisetron in controlling acu te 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.