ORAL DEXAMETHASONE FOR THE AMELIORATION OF THE GEMCITABINE-INDUCED SIDE-EFFECTS ASTHENIA, EDEMA, AND FLU-LIKE SYMPTOMS

Flu-like symptoms, asthenia, and edema are common side effects of gemc itabine treatment, occurring in up to 20% of all patients. The pathoph ysiologic mechanisms is currently unknown. We studied prospectively th e efficacy of prophylactically administered oral dexamethasone in pati ents with different tumor types, who were complaining of gemcitabine-i nduced side effects. Dexamethasone was given in a dosage of 8 mg prior to the gemcitabine infusion and 12 and 24 h later. The evaluation of the efficacy was performed with a detailed interview, prior to the nex t gemcitabine infusion. Of 35 patients studied, 27 noticed some side e ffects during gemcitabine treatment and received dexamethasone for the second or subsequent gemcitabine infusion. 24/27 patients noted a bet ter tolerance of the gemcitabine infusion. In 5 patients, edema dimini shed, 4 had no rash anymore, and 19 noted an improvement of asthenia a nd/or their general well-being. In 8/27 patients, omission of dexameth asone led these patients to request the drug routinely. Our results in dicate that oral dexamethasone at least ameliorates gemcitabine-induce d side effects in the majority of patients. A prospective, randomized, placebo-controlled study has been initiated to unequivocally prove th is effect.