Cancer Research and Treatment

Original Articles

Gynecologic cancer

Time-Trend Analysis and Risk Factors for Niraparib-Induced Nausea and Vomiting in Ovarian Cancer: A Prospective Study: Young Wook Jeong, Dongkyu Eugene Kim, Ji Hyun Kim, Se Ik Kim, Hyeong In Ha, Sang-Yoon Park, Myong Cheol Lim; Cancer Res Treat. 2025;57(3):865-872. Published online November 4, 2024; DOI: https://doi.org/10.4143/crt.2024.899

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Purpose
Nausea and vomiting are major non-hematological adverse events associated with niraparib maintenance therapy. This study aimed to investigate the time-trend patterns of niraparib-induced nausea and vomiting (NINV) and the associated risk factors in patients with ovarian cancer.
Materials and Methods
In this prospective study, we enrolled patients with stage III-IV epithelial ovarian cancer who received niraparib as frontline maintenance therapy. The clinicopathological characteristics and time-trend patterns of patients with NINV were collected through in-person surveys and electronic medical records from the National Cancer Center.
Results
Of 53 patients, 50 (94.3%) were diagnosed with high-grade serous ovarian carcinoma. BRCA mutations and homologous recombination deficiency (HRD) were identifi ed in 23 (43.4%) and 32 (60.4%) patients, respectively. Thirty-one patients (58.5%) had NINV. Time-trend analyses revealed that the fi rst peak intensity of NINV was reached at 3 h post-dose, and the second peak intensity was reached at 11 hour post-dose. NINV signifi cantly decreased from week 1 to weeks 8 and 12. In multivariate analyses of risk factors for NINV, HRD-positive tumors (p < 0.001) and prior experience of chemotherapy-induced nausea and vomiting (p=0.004) were associated with the occurrence of NINV.
Conclusion
Pre-emptive treatment with antiemetics is required to manage early-phase NINV during niraparib maintenance therapy in patients with risk factors. Additional larger studies are needed to confi rm these fi ndings and to develop optimal preventive strategies for NINV.

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Niraparib

Reactions Weekly.2025; 2076(1): 354. CrossRef

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Ramosetron versus Palonosetron in Combination with Aprepitant and Dexamethasone for the Control of Highly-Emetogenic Chemotherapy-Induced Nausea and Vomiting: Jin Hyoung Kang, Jung Hye Kwon, Yun-Gyoo Lee, Keon Uk Park, Ho Jung An, Joohyuk Sohn, Young Mi Seol, Hyunwoo Lee, Hwan-Jung Yun, Jin Seok Ahn, Ji Hyun Yang, Hunho Song, Dong-Hoe Koo, Jin Young Kim, Gun Min Kim, Hwa Jung Kim; Cancer Res Treat. 2020;52(3):907-916. Published online March 18, 2020; DOI: https://doi.org/10.4143/crt.2019.713

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Purpose
The purpose of this study was to compare ramosetron (RAM), aprepitant (APR), and dexamethasone (DEX) [RAD] with palonosetron (PAL), APR, and DEX [PAD] in controlling highly-emetogenic chemotherapy (HEC)–induced nausea and vomiting.
Materials and Methods
Patients were randomly assigned (1:1) to receive RAD or PAD:RAM (0.3 mg intravenously) or PAL (0.25 mg intravenously) D1, combined with APR (125 mg orally, D1 and 80 mg orally, D2-3) and DEX (12 mg orally or intravenously, D1 and 8 mg orally, D2-4). Patients were stratified by gender, cisplatin-based chemotherapy, and administration schedule. The primary endpoint was overall complete response (CR), defined as no emesis and no rescue regimen during 5 days of HEC. Secondary endpoints were overall complete protection (CP; CR+nausea score < 25 mm) and total control (TC; CR+nausea score < 5 mm). Quality of life was assessed by Functional Living Index Emesis (FLIE) questionnaire on D0 and D6.
Results
A total of 279 patients receiving RAD (n=137) or PAD (n=142) were evaluated. Overall CR rates in RAD and PAD recipients were 81.8% and 79.6% (risk difference [RD], 2.2%; 95% confidence interval [CI], −7.1 to 11.4), respectively. Overall CP and TC rates for RAD and PAD were 56.2% and 58.5% (RD, −2.3%; 95% CI, −13.9 to 9.4) and 47.5% vs. 43.7% (RD, 3.8%; 95% CI, −7.9 to 15.5), respectively. FLIE total score ≥ 108 (no impact on daily life) was comparable between RAD and PAD (73.9% vs. 73.4%, respectively). Adverse events were similar between the two groups.
Conclusion
In all aspects of efficacy, safety and QOL, RAD is non-inferior to PAD for the control of CINV in cancer patients receiving HEC.

Citations

Citations to this article as recorded by

Impact of body weight-based dosing of palonosetron and ondansetron on postoperative nausea and vomiting following laparoscopic sleeve gastrectomy: a randomized, double-blind study
Büşra Burcu, Nadir Adnan Hacım, Ozan Caliskan, Serdar Demirgan, Talar Vartanoglu Aktokmakyan, Serhat Meric, Tomris Duymaz, Onder Karabay, Ali Solmaz
Acta Chirurgica Belgica.2024; 124(1): 41. CrossRef
2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following high-emetic-risk antineoplastic agents
Jørn Herrstedt, L Celio, PJ Hesketh, L Zhang, R Navari, A Chan, M Saito, R Chow, M Aapro
Supportive Care in Cancer.2024;[Epub] CrossRef
2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting
J. Herrstedt, R. Clark-Snow, C.H. Ruhlmann, A. Molassiotis, I. Olver, B.L. Rapoport, M. Aapro, K. Dennis, P.J. Hesketh, R.M. Navari, L. Schwartzberg, M.L. Affronti, M.A. Garcia-Del-Barrio, A. Chan, L. Celio, R. Chow, M. Fleury, R.J. Gralla, R. Giusti, F.
ESMO Open.2024; 9(2): 102195. CrossRef
Ramosetron 3.0 μg/mL Combining with Dexamethasone (0.05, 0.1, 0.2 mg/mL) in Infusion Solutions: A Physicochemical Stability Study
Baoxia Fang, Lijun Zhao, Shirong Yu, Fuchao Chen
Dose-Response.2024;[Epub] CrossRef
Efficacy and safety of Antiemetic Regimens for Highly Emetogenic Chemotherapy-Induced Nausea and Vomiting: A Systematic Review and Network Meta-Analysis
Marco Filetti, Pasquale Lombardi, Raffaele Giusti, Rosa Falcone, Florian Scotte, Diana Giannarelli, Antonella Carcagnì, Valeria Altamura, Giovanni Scambia, Gennaro Daniele
Cancer Treatment Reviews.2023; : 102512. CrossRef
Effect of Acupuncture on Delayed Emesis for the Patients Who Received High-Emetogenic Chemotherapy with Standard Antiemetic Prophylaxis (KHMC-HO-01): An Open-Label, Randomized Study
Chi Hoon Maeng, Seunghoon Lee, Jae Joon Han, Hong Jun Kim, Dongwoo Nam, Junhee Lee, Sun Kyung Baek, Maria Grazia Ferraro
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Cardioprotective action of aprepitant in a rat model of ischemia-reperfusioninduced myocardial injury: role of PI3K-AkT-GSK-3β-HIF-1α signaling pathway
Mei Qian, Yang Liu
Acta Cirúrgica Brasileira.2022;[Epub] CrossRef
Comparison of the Effectiveness of Palonosetron and Ramosetron in Preventing Postoperative Nausea and Vomiting: Updated Systematic Review and Meta-Analysis with Trial Sequential Analysis
Hyo Jin Kim, EunJin Ahn, Geun Joo Choi, Hyun Kang
Journal of Personalized Medicine.2022; 13(1): 82. CrossRef
Oliceridine is Associated with Reduced Risk of Vomiting and Need for Rescue Antiemetics Compared to Morphine: Exploratory Analysis from Two Phase 3 Randomized Placebo and Active Controlled Trials
Timothy L. Beard, Cathy Michalsky, Keith A. Candiotti, Paul Rider, Linda Wase, Ashraf S. Habib, Mark A. Demitrack, Michael J. Fossler, Eugene R. Viscusi
Pain and Therapy.2021; 10(1): 401. CrossRef
Forsythiae Fructus aqueous extract attenuates cisplatin-induced kaolin consumption (pica) by inhibiting NLRP3 inflammasome activation in rats
Qi Meng, Pingping Bi, Guanglong Zhang, Yaqi Li, Siqi Chen, Ke Nie
Bioscience, Biotechnology, and Biochemistry.2021; 85(9): 2054. CrossRef
Antiemetics for adults for prevention of nausea and vomiting caused by moderately or highly emetogenic chemotherapy: a network meta-analysis
Vanessa Piechotta, Anne Adams, Madhuri Haque, Benjamin Scheckel, Nina Kreuzberger, Ina Monsef, Karin Jordan, Kathrin Kuhr, Nicole Skoetz
Cochrane Database of Systematic Reviews.2021;[Epub] CrossRef
Duration of dexamethasone administration for the prevention of chemotherapy-induced nausea and vomiting – A systematic review and meta-analysis
Ajay Raghunath, Sahan D. Chandrasekara, Shane N. Anthony, Ben Markman
Critical Reviews in Oncology/Hematology.2020; 152: 103012. CrossRef

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A Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Efficacy of Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately Emetogenic Chemotherapy: Results of the Korean South West Oncology Group (KSWOG) Study: So-Yeon Jeon, Hye Sook Han, Woo Kyun Bae, Moo-Rim Park, Hyeok Shim, Sang-Cheol Lee, Se-Il Go, Hwan Jung Yun, Yong-Jin Im, Eun-Kee Song; Cancer Res Treat. 2019;51(1):90-97. Published online February 27, 2018; DOI: https://doi.org/10.4143/crt.2017.577

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Purpose
Data on the efficacy of olanzapine in patients receiving moderately emetogenic chemotherapy (MEC) are limited. This study aimed to evaluate and compare the efficacy of olanzapine versus placebo in controlling nausea and vomiting in patients receiving MEC.
Materials and Methods
We conducted a randomized, double-blind, placebo-controlled study to determine whether olanzapine can reduce the frequency of chemotherapy-induced nausea and vomiting (CINV) and improve the quality of life (QOL) in patients receiving palonosetron and dexamethasone as prophylaxis for MEC-induced nausea and vomiting. The primary end point was complete response for the acute phase (0-24 hours after chemotherapy). The secondary end points were complete response for the delayed (24-120 hours) and overall phase (0-120 hours), proportion of significant nausea (visual analogue scale ≥ 25 mm), use ofrescue medications, and effect on QOL.
Results
Fifty-six patients were randomized to the olanzapine (n=29) and placebo (n=27) groups. Complete response rates were not significantly different between the olanzapine and placebo groups in the acute (96.5% vs. 88.0%, p=0.326), delayed (69.0% vs. 48.0%, p=0.118), and overall phases (69.0% vs. 48.0%, p=0.118). However, the percentage of patients with significant nausea (17.2% vs. 44.0%, p=0.032) and the use of rescue medications (0.03±0.19 vs. 1.88±2.88, p=0.002) were lower in the olanzapine group than in the placebo. Furthermore, the olanzapine group demonstrated better QOL (p=0.015).
Conclusion
Olanzapine combined with palonosetron and dexamethasone significantly improved QOL and vomiting control among previously untreated patients receiving MEC, although the efficacy was limited to the reduction of the frequency of CINV.

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Meenu Vijayan, Sherin Joseph, Haridas M Nair, Debnarayan Dutta, M.P. Narmadha
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Akihiro Uchiike, Haruka Kono, Katsuhiro Miura, Tatsuya Hayama, Daisuke Tsutsumi, Shinya Tsuboi, Susumu Ohtsuka, Shinji Hidaka
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Clinical Practices and Outcomes on Chemotherapy-Induced Nausea and Vomiting Management in South Korea: Comparison with Asia-Pacific Data of the Pan Australasian Chemotherapy Induced Emesis Burden of Illness Study: Myung Ah Lee, Eun Kyung Cho, Sung Yong Oh, Joong Bae Ahn, Ji Yun Lee, Burke Thomas, Hun Jung, Jong Gwang Kim; Cancer Res Treat. 2016;48(4):1420-1428. Published online February 12, 2016; DOI: https://doi.org/10.4143/crt.2015.309

Abstract PDF PubReader ePub

Purpose
This study reported patient outcomes of chemotherapy-induced nausea and vomiting (CINV) prophylaxis for highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC) regimens and evaluated its adherence to acute-phase CINV prophylaxis in the Korean population subset of the Pan Australasian Chemotherapy Induced Emesis burden of illness (PrACTICE) study. Materials and Methods This subgroup analysis evaluated 158 Korean patients receiving HEC or MEC and compared the data (wherever possible) with that of 648 patients from the Asia-Pacific (AP) region. Study endpoints included evaluation of primary CINV prophylaxis and adherence to acutephase CINV prophylaxis in cycle 1 (American Society of Clinical Oncology [ASCO] Quality Oncology Practice Initiative [QOPI]).
Results
In South Korea and the AP, a 5-hydroxytryptamine-3 receptor antagonist (5HT3-RA) prophylaxis for the acute phase was administered to 79/80 patients (98.8%) for HEC and 70/71 patients (98.6%) for MEC regimens (QOPI-1). Triple regimen (corticosteroid–5HT3-RA–neurokinin 1-RA) was initiated in 46/80 patients (57.5%) for prophylaxis of acute CINV in cycle 1 of HEC (QOPI-3). Double regimen (corticosteroid–5HT3-RA, with or within NK1-RA) was initiated in 61/71 patients (83.1%) for control of acute CINV in cycle 1 of MEC a(QOPI-2). Conclusion Active management of CINV is necessary in cycle 1 of HEC in South Korea, despite higher rates than the AP region. Adherence to the international guidelines for CINV prophylaxis requires attention in the acute phase in cycle 1 of the HEC regimen.

Citations

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Adherence to antiemetic guidelines in solid cancer patients receiving highly emetogenic chemotherapy in Korea
Ryugyoung Lee, Minhee Ku, Nam Kyung Je
Supportive Care in Cancer.2024;[Epub] CrossRef
Chemotherapy-Associated Nausea and Vomiting
Kelvin Mogesa Manyega, Benjamin Nasara Joseph, Okunlola Charity Rotkangmwa, Maxwell P. Dapar
Annals of African Medicine.2022; 21(2): 124. CrossRef
Expert Consensus on Effective Management of Chemotherapy-Induced Nausea and Vomiting: An Indian Perspective
Ashok K. Vaid, Sudeep Gupta, Dinesh C. Doval, Shyam Agarwal, Shona Nag, Poonam Patil, Chanchal Goswami, Vikas Ostwal, Sagar Bhagat, Saiprasad Patil, Hanmant Barkate
Frontiers in Oncology.2020;[Epub] CrossRef
Construção e avaliação de bundle frente ao extravasamento de antineoplásicos: estudo metodológico
João Marcos Alves Melo, Patrícia Peres de Oliveira, Andrea Bezerra Rodrigues, Raíssa Silva Souza, Deborah Franscielle da Fonseca, Thaís Fonseca Gontijo, Edilene Aparecida Araújo da Silveira
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A cost-utility analysis of risk model-guided versus physician’s choice antiemetic prophylaxis in patients receiving chemotherapy for early-stage breast cancer: a net benefit regression approach
Kednapa Thavorn, Doug Coyle, Jeffrey S. Hoch, Lisa Vandermeer, Sasha Mazzarello, Zhou Wang, George Dranitsaris, Dean Fergusson, Mark Clemons
Supportive Care in Cancer.2017; 25(8): 2505. CrossRef

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A Phase II Study to Evaluate the Efficacy of Ramosetron, Aprepitant, and Dexamethasone in Preventing Cisplatin-Induced Nausea and Vomiting in Chemotherapy-Naive Cancer Patients: Geundoo Jang, Hun Ho Song, Keon Uk Park, Hyeong Su Kim, Dae Ro Choi, Jung Hye Kwon, Ho Young Kim, Boram Han, Jung Han Kim, Joo Young Jung, Hyo Jung Kim, Dae Young Zang; Cancer Res Treat. 2013;45(3):172-177. Published online September 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.3.172

Abstract PDF PubReader ePub

PURPOSE
Combination therapy with aprepitant, serotonin receptor antagonist, and steroids improves the complete response rate of both acute and delayed chemotherapy-induced nausea and vomiting (CINV). However, it is not known whether ramosetron is suitable for administration in combination with aprepitant. Therefore, we conducted a multicenter, open-label, prospective, phase II study in order to assess the efficacy and tolerability of combination therapy with ramosetron, aprepitant, and dexamethasone (RAD) for prevention of cisplatin-based CINV in chemotherapy-naive patients with solid cancers.
MATERIALS AND METHODS
Forty-one patients with various solid cancers (31 male and 10 female; median age, 59 years) who received treatment with highly emetogenic chemotherapy (median cisplatin dose, 70 mg/m2; range 50 to 75 mg/m2) were enrolled in this study. Oral aprepitant (125 mg on day 1; 80 mg on days 2 and 3), intravenous ramosetron (0.6 mg on day 1), and oral dexamethasone (12 mg on day 1; 8 mg on days 2-4) were administered for prevention of CINV.
RESULTS
The complete response (no emesisand retching and no rescue medication) rate was 94.9% in the acute period (24 hours post-chemotherapy), 92.3% in the delayed period (24-120 hours post-chemotherapy), and 92.3% in the overall period (0-120 hours). The absolute complete response (complete response plus no nausea) rate was 74.4% in the acute period, 51.3% in the delayed period, and 46.2% in the overall period. There were no grade 3 or 4 toxicities related to these antiemetic combinations.
CONCLUSION
RAD regimen is a safe and effective antiemetic treatment for prevention of CINV in patients receiving highly emetogenic chemotherapy.

Citations

Citations to this article as recorded by

Ramosetron Versus Ondansetron in Combination With Aprepitant and Dexamethasone for the Prevention of Highly Emetogenic Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Randomized Phase III Trial, KCSG PC10-21
Hyo Jung Kim, Sang Won Shin, Eun-Kee Song, Na-Ri Lee, Jun Suk Kim, Jin Seok Ahn, Hwan-Jung Yun, Yo-Han Cho, Keon Uk Park, Si-Young Kim, Joung Soon Jang, Sang-We Kim, Hyun Woo Lee, Se Ryeon Lee, Yang Soo Kim, Soon Nam Lee, Yoon Ho Ko, Hwa Jung Kim, Jin-Hyo
The Oncologist.2015; 20(12): 1440. CrossRef
Assessment of low-dose cisplatin as a model of nausea and emesis in beagle dogs, potential for repeated administration
Hannah Kenward, Ludovic Pelligand, Jonathan Elliott
Experimental Brain Research.2014; 232(8): 2685. CrossRef
Anticipatory nausea in animal models: a review of potential novel therapeutic treatments
Erin M. Rock, Cheryl L. Limebeer, Linda A. Parker
Experimental Brain Research.2014; 232(8): 2511. CrossRef

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Open-label, Randomized Comparison of the Efficacy of Intravenous Dolasetron Mesylate and Ondansetron in the Prevention of Acute and Delayed Cisplatin-induced Emesis in Cancer Patients: Jin-Soo Kim, Ji Yeon Baek, Sook Ryun Park, In Sil Choi, Sang-Il Kim, Dong-Wan Kim, Seock-Ah Im, Tae-You Kim, Dae Seog Heo, Yung-Jue Bang, Noe Kyeong Kim; Cancer Res Treat. 2004;36(6):372-376. Published online December 31, 2004; DOI: https://doi.org/10.4143/crt.2004.36.6.372

Abstract PDF PubReader ePub

Purpose

The aim of this study is to compare the antiemetic efficacy and tolerability of intravenous dolasetron mesylate and ondansetron in the prevention of acute and delayed emesis.

Material and Methods

From April 2002 through October 2002, a total of 112 patients receiving cisplatin- based combination chemotherapy were randomized to receive a single i.v. dose of dolasetron 100 mg or ondansetron 8 mg, 30 minutes before the initiation of chemotherapy. In the ondansetron group, two additional doses of ondansetron 8 mg were given at intervals of 2 to 4 hours. To prevent delayed emesis, dolasetron 200 mg p.o. daily or ondansetron 8 mg p.o. bid was administered from the 2^nd days to a maximum of 5 days. The primary end point was the proportion of patients that experienced no emetic episodes and required no rescue medication (complete response, CR) during the 24 hours (acute period) and during Day 2 to Day 5±2 days (delayed period), after chemotherapy. The secondary end points included the incidence and severity of emesis.

Results

105 patients were evaluable for efficacy. CR rates during the acute period were 36.0% for a single dose of dolasetron 100 mg, and 43.6% for three doses of ondansetron 8 mg. CR rates during the delayed period were 8.0% and 10.9%, respectively. There was no significant difference in the efficacy between the two groups. Adverse effects were mostly mild to moderate and not related to study medication.

Conclusions

A single i.v. dose of dolasetron 100 mg is as effective as three i.v. doses of ondansetron 8 mg in preventing acute and delayed emesis after cisplatin-based chemotherapy, with a comparable safety profile.

Citations

Citations to this article as recorded by

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Hongxia Xu, Jiankun Xing, Shaohui Yang, Lingyan Rong, Lingyan Liu, Xiaotao Chen
PeerJ.2026; 14: e21047. CrossRef
Efficacy, safety and effectiveness of ondansetron compared to other serotonin-3 receptor antagonists (5-HT3RAs) used to control chemotherapy-induced nausea and vomiting: systematic review and meta-analysis
Giovana Paula Rezende Simino, Lays Pires Marra, Eli Iola Gurgel de Andrade, Francisco de Assis Acúrcio, Ilka Afonso Reis, Vânia Eloisa De Araújo, Mariângela Leal Cherchiglia
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Interventions to decrease the risk of adverse cardiac events for patients receiving chemotherapy and serotonin (5-HT3) receptor antagonists: a systematic review
Andrea C Tricco, Charlene Soobiah, Wing Hui, Jesmin Antony, Vladi Struchkov, Brian Hutton, Brenda Hemmelgarn, David Moher, Sharon E Straus
BMC Pharmacology and Toxicology.2015;[Epub] CrossRef

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Effect of One - day ( G1 ) and Two - day ( G2 ) Schedule of Intravenous Granisetron on Prevention of nausea and Vomiting and Qualit Of Life during Cisplatin - Containin: Woo Sung Min, Han Lim Moon, Jin Hyoung Kang, Jong Youl Jin, Choon Choo Kim, Dong Jip Kim, Seong Ja Choo, Kyung Shim Kang, Jae Boon Ryu; J Korean Cancer Assoc. 1996;28(3):573-582.

Abstract PDF: Background
Nausea/vomiting is one of the most important item on deterioration of quality of life(QOL) in patients with cisplatin-containing chematherapy and may ultimately result in delay or refusal of the next chemotherapy. Although 5-hydroxy tryptamine 3(5-HT3) antagonist, ondansetron successfully controls cisplatin-induced nausea/vomiting during the first 24 hours, it fails to control nausea/vomiting on the following 24 hours in many patients. Authors performed this study to compare the effect of one-day and two-day schedule of intravenous granisetron on prevention of cisplatin-induced nausea and vomiting and QOL. Method: The antiemtic effect and QOL between one-day and two-day schedule of 3 mg/day of intravenous granisetron in cycle 1 and cycle 2 of cisplatin-based chemotherapy were compared. Frequency and severity of nausea/vomiting, QOL, oral intake and side effects were evaluated daily since day 0 to day 7 of chemotherapy. Results: Thirty eight patients were enrolled and 37 patients(31 male, 6 female, median age 60 with range of 42~74) were evaluable. The range of cisplatin were 50~l00mg/§³ and one or two of other chemotherapeutic agents such as 5FU, VP16, ifosfamide and mitomycin were combined. We evaluated the number of vomiting and QOL index with 10 items including nausea/vomiting and anorexia from day 0 to day 7 of chemotherapy. Twelve of 37 could not receive the G2 because of discontinuation of chemotherapy or patient's refusal of granisetron any more and eventually 25 had both Gl and G2. Time to first vomiting, control of vomiting and the amount of oral intake on day 1, day 2 and the worst day and side effects were not different between Gl and G2. QOL on day 2(G1; 56.2¡¾16.2 vs G2; 68.4¡¾20.3)(p<0.05) and change of QOL since day 1 to day 2 of cispltin(Gl; 16.3+2.1 vs G2 0.07+0.6)(p<0.01) were significantly different. Conclusion: Although the additiional intravenous granisetron on day 2 of cisplatin-based chemotherapy did not control nausea/vomiting more successfully, it improved QOL on the second day and the change of QOL from day 1 to day 2.

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Effect of Granisetron in the Prevention of Nausea and Vomiting Associated with Cisplatin Containing Chemotherapy: Yeul Hong Kim, Byung Soo Kim, Suk Jin Kim, Sang Chul Oh, Sang Won Shin, Jun Suk Kim; J Korean Cancer Assoc. 1996;28(4):748-761.

Abstract PDF: Background
Granisetron is a new, highly selective 5-TH antagonist with a long half life which has been shown to be highly effective at one dose per day in the prevention of nausea and vomiting induced by cisplatin containing chemotherapy. We evaluated the efficacy and safety of granisetron to prevent nausea and vomiting induced by multiple low dose cisplatin containing regimen or single high dose cisplatin containing regimen. Methods: From December 1994 to December 1995, 44 consecutive chemotherapy-naive patients who were to receive cisplatin containing reaimen, were enrolled in this study. Twenty four patients, who were treated with multiple low dose cisplatin were classified as group I and 20 patients, who were treated with single high dose cisplatin were classified as group II. On the first day of chemotherapy, the patients had received granisetron(3 mg/ 3 ml) at 5 minutes prior to cisplatin injection. And then, the patients checked the degree of nausea and the number of vomiting, at every 24 hours for 6 days by themselves. According to the criteria of Italian Group of Antiemetic Research (IGAR), we regarded the none and mild nausea as the surcessful control of nausea and the complete and major response of vomiting as the successful control of vomiting. Also, complete and major response by the criteria of Soukop and Smith was regarded as the successful control. Results: 1) At first 24 hours, nausea control was achieved in 84%(20 cases) and vomiting control was achieved in 88%(21 cases) of the group I patients by the criteria of IGAR and 88%(21 cases) of the group I patients had successful control by the criteria of Soukop and Smith. At second and third day, when cisplatin administration was continued, nausea control rate was 59%(14 cases), 33%(8 cases), respectively and vomiting control rate was 67% (16 cases) at both days by the criteria of IGAR. According to the criteria of Soukop and Smith, control rate was 63%(15 cases) and 58%(14 cases) at second and third day in group I patients, respectively. 2) At first 24 hours, nausea control was aehieved in 85%(l7 cases) and vomiting control was achieved in 95%(19 cases) of the group II patients by the criteria of IGAR and 75%(15 cases) of the group II patients had successful control by the criteria of Soukop and Smith. After cisplatin administration, symptoms were aggravated temporally during day 2 and recovered gradually. After day 1, nausea control rate was 55~90% and vomiting control rate was 75~100% in group II patients. 3) Rescue therapy was attempted in 3 cases of group I patients and 6 cases of group II patients. Six out of those nine patients got improved and additional granisetron administration as a rescue therapy was quite effective. 4) The observed side effects of granisetron were dizziness(2 cases), headache(l case), and diarrhea(1 case), which were improved without any therapy. Conelusion: These results suggested that granisetron was well tolerable and effective for the control of nausea and vomiting induced by cisplatin containing chemotherapy with the convenience of single injection.

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Comparison of Tropisetron with Ondansetron in the Prevention of Cisplatin-induced Nausea and Vomiting: Kyung Shick Lee, Ji Youn Han, Hanlim Moon, Bok Kun Lee, Seok Goo Cho, Jong Youl Jin, Young Sun Hong, Hoon Kyo Kim; J Korean Cancer Assoc. 1997;29(2):332-339.

Abstract PDF: PURPOSE
Tropisetron (Nabovan (R)) is a new specific 5-HT3 receptor antagonist with a long terminal half life in plasma and high bioavailability after oral intake. We compared the antiemetic effectiveness and tolerability of tropisetron with ondansetron in the highly emetogenic chemotherapy (including cisplatin > or =50 mg/m2).
MATERIALS AND METHODS
Thirty-nine patients were administered in a randomized, multicenter, open, cross-over study and received either tropisetron plus dexamethasone (n=31) or ondansetron plus dexamethasone (n=34) during six days of two successive cycles of chemotherapy.
RESULTS
Total control of vomiting with either Ondansetron or tropisetron was 94.2 % vs 93.5 % in D1 (P=0.157); 90.6 % vs 93.1 % in D2 (P=0.18); 90.3 % vs 93.1 % in D3 (P=0.655); 96.4% vs 96.4 % in D4 (P=0.157); 96.4 % vs 100 % in D5 (P=0.317); 96.4 % vs 100% in D6, respectively. The duration of nausea showed significant decreasements in tropisetron at D5 and D6 (P=0.025, P=0.03, respectively), but the severity of nausea and performance status showed no significance. Headache and constipation were the most common side effects in both groups.
CONCLUSION
There was no significant difference in efficacy and tolerability between tropisetron and ondansetron in the cisplatin-based chemotherapy.

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Nausea and Vomiting Induced by Conventional Fractionated Radiotherapy on Abdomen: Won Dong Kim, Woo Yoon Park; J Korean Cancer Assoc. 2000;32(4):757-763.

Abstract PDF: PURPOSE
A retrospective study was intended to assess the incidence, severity, and risk factors of abdominal radiotherapy induced nausea and vomiting and to evaluate the effect of antiemetic drugs like metoclopramide and ondansetron.
MATERIALS AND METHODS
From October 1997 to October 1999, we enrolled 48 patients who received conventional fractionated radiotherapy on abdomen. Patients under 18 years old and who received concomittant chemotherapy were excluded. Evaluation was carried out on the basis of daily check of the intensity of nausea and any episode of vomiting and retching.
RESULTS
Nausea and vomiting occurred in 65% and 25% of patients, respectively. On multivariate analysis, previous experience with chemotherapy was the only significant patients-related risk factor. The irradiated site and field size were also significant in terms of radiotherapy-related risk factors. Nausea and vomiting were markedly diminished in the group given ondansetron.
CONCLUSION
Our study offered useful data on general picture of radiation induced nausea and vomiting in patients given conventional fractionated radiotherapy on abdomen. For the patients with risk factors, prophylactic antiemetic drug prescription may be mandatory to enhance compliance with radiotherapy and ondansetron is more effective than metoclopramide for controlling nausea and vomiting.

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