Antiemetic efficacy of granisetron: a randomized crossover study in patients receiving cisplatin-containing intraarterial chemotherapy

Background: Cisplatin (CDDP) is one of the most active chemotherapeutic age nts but is among the most emetogenic drugs. The emetic side-effects of CDDP -containing intraarterial chemotherapy have not been evaluated in a prospec tive randomized trial and the efficacy of serotonin antagonists in preventi ng the emesis associated with this method of CDDP administration has not be en assessed. Methods: CDDP 50 mg/m(2) and methotrexate 30 mg/m(2) were administered ever y 3 weeks through intraarterial catheters placed in the bilateral internal iliac arteries. Patients were classified into two groups: granisetron treat ment group (group G) and no treatment group (group NG) with the first cours e of chemotherapy, crossing over with the second course. The patients in gr oup G received granisetron 40 mu g/kg by intravenous infusion. Results: Although intraarterial CDDP administration produced less emesis th an intravenous CDDP administration, at the same concentration, gastrointest inal toxicity is still the most unpleasant side-effect for patients. Granis etron administration significantly reduced nausea and vomiting during the a cute emetic phase tan evaluation of treatment as very effective and effecti ve was made in 89% in group G and 33% in group NG (P< 0.001). Complete cont rol of emesis was achieved in 68 and 18% of patients in groups G and NG, re spectively (P< 0.0001). Conclusion: A single prophylactic infusion of granisetron was effective in preventing the nausea and vomiting associated with intraarterial CDDP-conta ining therapy.