OUTCOMES OF ANTIEMETIC THERAPY AFTER THE ADMINISTRATION OF HIGH-DOSE ANTINEOPLASTIC AGENTS

Patterns of antiemetic therapy and its outcomes in patients undergoing high-dose antineoplastic therapy were studied. The study, conducted a t a cancer center, included both a retrospective evaluation of patient s undergoing highly emetogenic high-dose chemotherapy with peripheral blood stem-cell rescue between November 1994 and December 1995 and a c oncurrent evaluation of patients treated between January and May 1996. During the study period the recommended antiemetic regimen for highly emetogenic chemotherapy was a single dose of granisetron 1 mg i.v. da ily 30 minutes before treatment on days of chemotherapy. Severity of n ausea and vomiting during both the acute phase (from day 1 of chemothe rapy to 24 hours after its completion) and delayed phase (from 24 hour s to five days after the end of chemotherapy) was graded according to the Common Toxicity Criteria Grading Scale. A total of 59 patients wer e evaluable; 41 were reviewed retrospectively, and 18 were reviewed co ncurrently. On day 1 of the acute phase, 53 patients (90%) had no vomi ting and 51 patients (86%) had no nausea. The frequency and severity o f nausea and vomiting increased on successive acute-phase days, and it was necessary to add other antiemetics. Nausea and vomiting continued to be significant problems throughout the delayed phase; 32 (54%) of the patients had a maximum of grade 3 nausea, and 29 patients (49%) ha d a maximum of grade 2 vomiting. Substantial numbers of patients who r eceived selective serotonin type 3 receptor antagonists before high-do se antineoplastic agents had significant nausea and vomiting that requ ired the addition of other antiemetics.