Abstract
-
Results
- The efficacy of controlling nausea with an ondansetron regimen and a ramosetron regimen and an aprepitant regimen was 85.29%, 78.26%, 80% in acute periods (P-value = 0.037) and 88.23%, 98.26%, 87.5% in delayed periods (P-value = 0.000), respectively. The efficacy of controlling vomiting with an ondansetron regimen and a ramosetron regimen and an aprepitant regimen and an ondansetron regimen was 82.35%, 97.3%, 90% in acute periods (P-value=0.002) and 82.35%, 100%, 95% in delayed periods (P-value = 0.000), respectively. The common adverse effects in each groups were not significantly.
-
Conclusions
- Appropriate to each patient’s symptoms, the choice of drugs will be needed since each of the drugs have different effects on vomiting. Even though the each antiemetic drug has good efficacy, the effect of the drug is not complete. Therefore the use of additional drugs are also needed.
-
Objectives
- Chemotherapy induced nausea and vomiting is most distressing adversed effects in gynecologic cancer patients receiving chemotherapy. we compared effectiveness of ondansetron and ramosetron and aprepitant for optimal antiemetic treatment in gynecologic cancer patient receiving chemotherapy.
-
Methods
- The study was performed retrospective on 189 patients who was diagnosed initially the gynecological cancer during chemotherapy at Kosin university hospital between January 2008 and December 2010. The efficacy of controlling acute/delayed nausea and vomiting were analyzed by counting numbers of nausea and vomiting reported in medical records of 189 patient receiving cisplatin-based chemotherapy. Statistical analysis was performed using the ANOVA and Fisher’s exact chi-square test.
-
Results
- The efficacy of controlling nausea with an ondansetron regimen and a ramosetron regimen and an aprepitant regimen was 85.29%, 78.26%, 80% in acute periods (P-value = 0.037) and 88.23%, 98.26%, 87.5% in delayed periods (P-value = 0.000), respectively. The efficacy of controlling vomiting with an ondansetron regimen and a ramosetron regimen and an aprepitant regimen and an ondansetron regimen was 82.35%, 97.3%, 90% in acute periods (P-value=0.002) and 82.35%, 100%, 95% in delayed periods (P-value = 0.000), respectively. The common adverse effects in each groups were not significantly.
-
Conclusions
- Appropriate to each patient’s symptoms, the choice of drugs will be needed since each of the drugs have different effects on vomiting. Even though the each antiemetic drug has good efficacy, the effect of the drug is not complete. Therefore the use of additional drugs are also needed.
-
Keywords: Antiemetics; Chemotherapy induced nausea and vomiting; Chemotherapy
Table 1.연구대상 환자군의 임상양상
Characteristics |
No. of patients
|
P-value |
A (n = 40) |
O (n = 34) |
N (n = 115) |
Age |
57.1 ± 8.0 |
54.0 ± 6.4 |
53.47 ± 12.9 |
0.202 |
Cancer |
|
|
|
0.013 |
o |
10 |
12 |
58 |
|
c |
30 |
22 |
57 |
|
Chemo |
|
|
|
0.000 |
FP |
10 |
13 |
40 |
|
CT |
30 |
21 |
43 |
|
Other |
0 |
0 |
32 |
|
Performance |
|
|
|
0.004 |
0 |
26 |
22 |
96 |
|
1 |
11 |
10 |
19 |
|
2 |
3 |
2 |
0 |
|
Table 2.Aprepitant, Ondansetron, Ramosetron 요법의 오심에 대한 조절 효과
|
Grade |
A (n = 40) |
O (n = 34) |
N (n = 115) |
P-value |
Acute |
0 |
23 |
22 |
44 |
0.037 |
|
1 |
9 |
7 |
46 |
|
|
2 |
8 |
5 |
24 |
|
|
3 |
0 |
0 |
0 |
|
Delayed |
0 |
26 |
19 |
102 |
0.000 |
|
1 |
9 |
11 |
11 |
|
|
2 |
5 |
4 |
2 |
|
|
3 |
0 |
0 |
0 |
|
Table 3.Aprepitant, Ondansetron, Ramosetron 요법의 구토에 대한 조절 효과
|
Grade |
A (n = 40) |
O (n = 34) |
N (n = 115) |
P-value |
Acute |
0 |
27 |
21 |
100 |
0.002 |
|
1 |
9 |
7 |
12 |
|
|
2 |
4 |
6 |
3 |
|
|
3 |
0 |
0 |
0 |
|
Delayed |
0 |
31 |
18 |
112 |
0.000 |
|
1 |
7 |
10 |
3 |
|
|
2 |
2 |
6 |
0 |
|
|
3 |
0 |
0 |
0 |
|
Table 4.Aprepitant, Ondansetron, Ramosetron 요법 간의 부작용
|
Aprepitant
|
Ondant
|
Nasea
|
N |
Sum |
N |
Sum |
N |
Sum |
Dizziness |
0 |
|
2 |
2 |
9 |
15 |
Diarrhea |
7 |
11 |
6 |
8 |
5 |
10 |
Constipation |
5 |
6 |
6 |
8 |
17 |
19 |
Epi. Soreness |
3 |
3 |
4 |
4 |
21 |
44 |
Anorexia |
6 |
6 |
5 |
5 |
25 |
37 |
Headache |
3 |
3 |
4 |
4 |
11 |
12 |
Itching |
1 |
1 |
1 |
1 |
10 |
12 |
References
- 1.Ji Yeung Oh, Chun June Lee. Comparative study of an aprepitant regimen with an ondansetron regimen, for efficacy in gynecological cancer patients with chemotherapy. Korean Journal of Obstetrics and Gynecology 2009;5:538–44.
- 2.Richardson JL, Mark G, Levine A. Theinfluence of symptoms of vomiting with cytotoxic chemotherapy. hournal of Clinical Oncology 1988;6(11):1746–52.
- 3.Morran C, Smith DC, Anderson DA, et al. Incidence of nausea and vomiting with cytotoxic chemotherapy: a prospective randomized trial of antiemetics. BJM 1979;1:1323–9.
- 4.Harmon J, John HW. Control of cancer chemotherapy induced nausea and vomiting. Cancer 1984;54:2642–50.ArticlePubMed
- 5.Hmosley HD, Gainey JM, Jobson VW, et al. Double blind placebo controlled study of metoclopramide. N Engl J Med 1982;307:250–9.
- 6.Bateman DN, Rawlins MD, Simpson JM. Extrapyramidal rreactions with metocloprimide. BKM 1982;291:930–9.
- 7.Roila F, Donati D, Tamberi S, Margutti G. Delayed emesis: incidence, pattern, prognostic factors and optimal treatment. Support Care Cancer 2002;10:88–95.ArticlePubMed
- 8.Hesketh PJ, Van Belle S, Aapro M, Tattersall FD, Naylor RJ, Hargreaves R, et al. Differential involvement of neurotransmitters through the time course of cisplatin-induced emesis as revealed by therapy with specific receptor antagonists. Eur J Cancer 2003;39:1074–80.ArticlePubMed
- 9.Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de Wit R, et al. The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebocontrolled trial in patients receiving high-dose cisplatin-the Aprepitant Protocol 052 Study Group. J Clin Oncol 2003;21:4112–9.ArticlePubMed
- 10.Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, Julie Ma G, Eldridge K, Hipple A, et al. Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo- controlled trial in Latin America. Cancer 2003;97:3090–8.ArticlePubMed
- 11.Leibundgut U, Lancranjan I. First results with ICS 205-930 (5-HT3 receptor antagonist) in prevention of chemotherapy-induced emesis. Lancet 1987;1:1198.Article
- 12.Ballatori E, Roila F, De Angelis V, Ciccarese G, Palladino MA, Tonato M, et al. Clinical and methodological issues in antiemetic therapy: a worldwide survey of experts' opinions. Multinational Association of Supportive Care in Cancer. Support Care Cancer 1997;5:269–73.PubMed
- 13.Gebbia V, Cannata G, Testa A, Curto G, Valenza R, Cipolla C, et al. Ondansetron versus granisetron in the prevention of chemotherapy-induced nausea and vomiting. Results of a prospective randomized trial. Cancer 1994;74:1945–52.ArticlePubMed
- 14.Ballatori E, Roila F, De Angelis V, Ciccarese G, Palladino MA, Tonato M, et al. Clinical and methodological issues in antiemetic therapy: a worldwide survey of experts' opinions. Multinational Association of Supportive Care in Cancer. Support Care Cancer 1997;5:269–73.PubMed
- 15.Gralla RJ. Metoclopramide. A review of antiemetic trials. Drugs 1983;25(Suppl 1):63–73.Article
- 16.Gralla RJ, Osoba D, Kris MG, Kirkbride P, Hesketh PJ, Chinnery LW, et al. Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines. American Society of Clinical Oncology. J Clin Oncol 2002;17:2971–94.
- 17.Roila F, Tonato M, Cognetti F, Cortesi E, Favalli G, Marangolo M, et al. Prevention of cisplatininduced emesis: a double-blind multicenter randomized crossover study comparing ondansetron and ondansetron plus dexamethasone. J Clin Oncol 1991;9:675–8.ArticlePubMed
- 18.Min SH, Kim DS, Cho YS, Nam SW, Kim IS, Lim JW, et al. A Phase III Study of Ondansetron & Metoclopramide in the Management of Cisplatin-Induced Emesis. Korean Journal of Obstetrics & Gynecology 1994;37:542–51.
- 19.Kim YB, Kim JW, Seo DG, Lee CM, Park NH, Song YS, et al. A Randomized Comparison of Tropisetron versus Ondansetron in the Control of Nausea and Vomiting in Gynecologic Cancer Patients Undergone Cisplatin-Based Chemotherapy. Korean Journal of Obstetrics & Gynecology 1998;41:2544–50.
Citations
Citations to this article as recorded by