R. Miralbell et al., NAUSEA AND VOMITING IN FRACTIONATED RADIOTHERAPY - A PROSPECTIVE ON-DEMAND TRIAL OF TROPISETRON RESCUE FOR NONRESPONDERS TO METOCLOPRAMIDE, European journal of cancer, 31A(9), 1995, pp. 1461-1464
A prospective trial was performed to better assess the risk of nausea
and vomiting and the rescue value of tropisetron (TRO), a 5-HT3 recept
or antagonist, in 88 patients undergoing fractionated radiotherapy to
the abdomen or to large supradiaphragmatic fields and failing a first
anti-emetic trial with metoclopramide (MET). Nausea was graded 0 (abse
nt), 1 (mild), 2 (moderate) and 3 (severe). Nausea requiring anti-emet
ics (greater than or equal to grade 2) was present in 64% of the patie
nts. MET was able to control nausea (less than or equal to grade 1) in
26 of 58 patients (45%) who developed greater than or equal to grade
2 nausea during radiation treatment (2 patients vomiting without nause
a included). 34 patients required TRO, and 31 experienced immediate re
lief. However, nausea (greater than or equal to grade 2) recurred in 7
patients from 1 to 3 weeks after starting TRO. Sex, age, field type a
nd held size (cm(2)) did not influence the incidence and severity of n
ausea and vomiting. Only 24/88 patients vomited after starting radioth
erapy. MET helped to eliminate emesis in one third of these patients.
TRO helped to control vomiting in 73% of the salvaged patients. Consti
pation was observed in 8 patients on TRO and was a reason to stop the
medication in 4 cases.