Ja. Trovato et al., OUTCOMES OF ANTIEMETIC THERAPY AFTER THE ADMINISTRATION OF HIGH-DOSE ANTINEOPLASTIC AGENTS, American journal of health-system pharmacy, 55(12), 1998, pp. 1269-1274
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.