Comparative Study of an Ondansetron and a Ramosetron an Aprepitant in the Control of Nausea and Vomiting in Gynecologinc Cancer Patient with Chemotherapy

HANGGOO Yun; Heung Yeol Kim; Eun ae Jeh

doi:10.7180/kmj.2013.28.2.115

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Original Article Comparative Study of an Ondansetron and a Ramosetron an Aprepitant in the Control of Nausea and Vomiting in Gynecologinc Cancer Patient with Chemotherapy: HANGGOO Yun, Heung Yeol Kim, Eun ae Jeh; Kosin Medical Journal 2013;28(2):115-121.
DOI: https://doi.org/10.7180/kmj.2013.28.2.115
Published online: January 19, 2013

Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea

Corresponding author: Heung Yeol Kim, Department of Obstetrics and Gynecology, College of Medicine, Kosin University, 34 Amnamdong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6226 FAX: +82-51-990-3300 E-mail: hykyale@yahoo.com

• Received: October 2, 2012 • Accepted: January 10, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
References

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
Characteristics	A (n = 40)	O (n = 34)	N (n = 115)	P-value
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

Statistics were analyzed by ANOVA and Fisher’s exact chi-square test. mean ± SD, frequency (%).

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

Statistics were analyzed by Fisher’s exact chi-square test.

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

Statistics were analyzed by Fisher’s exact chi-square test.

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

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2.Richardson JL, Mark G, Levine A. Theinfluence of symptoms of vomiting with cytotoxic chemotherapy. hournal of Clinical Oncology 1988;6(11):1746–52.
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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.Article PubMed
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Comparative Study of an Ondansetron and a Ramosetron an Aprepitant in the Control of Nausea and Vomiting in Gynecologinc Cancer Patient with Chemotherapy

Kosin Med J. 2013;28(2):115-121. Published online January 19, 2013

DOI: https://doi.org/10.7180/kmj.2013.28.2.115

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Comparative Study of an Ondansetron and a Ramosetron an Aprepitant in the Control of Nausea and Vomiting in Gynecologinc Cancer Patient with Chemotherapy

연구대상 환자군의 임상양상

Characteristics	No. of patients			P-value
Characteristics	A (n = 40)	O (n = 34)	N (n = 115)	P-value
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

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

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

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