Twenty patients with advanced stomach cancer receiving combination chemotherapy with 5- fluorouracil and cisplatin were entered into an antiemetic randomized crossover trial. All patients had previously untreated adenocarcinoma of the stomach with metastasis beyond surgical resection, but no pyloric obstruction. Thirteen patients (Group A) have received 1,000 mg/m of -fluarouracil on day 1-5 and 80 mg/m of cisplatin on day 1. Fourteen patients (Group B) have received 1,000 mg/m of 5-fluorouracil and 20 mg/m of cisplatin on day 1-5. Seven patients (A-1) of group A have treated with metoclopramide (2 mg/kg i. v. bid. on day 1) and no antiemetics on day 2-5. Six patients (A-2) of group A have treated with metoclopramide (2 mg/kg i. v, bid. on day 1) and Motilium suppository (1 capsule = 60 mg of domperidone, bid. on day 2-5). Eight patients (B-1) of group B have treated with metoclopramide alone (I mg/kg i. v. bid. on day 1-5). Six patients (B-2) of group B have treated with Motilium suppository (I capsule per rectal. bid. on day 2-5). Response of vomiting was determined as the percentage of patients with less than two times of vomiting per day to all patients studied. Nausea was classified into four groups; no nausea, mild degree, moderate degree and severe degree. Response of nausea was determined as the percentage of patients with no and mild degree of nausea to all patients studied. Response rate on day #1 was similar between A-1 (43%) and A-2 (50%). Response rates of vomiting and nausea on day 2-5 in A-2 (95% and 54%, respectively) were not significantly different from those of A-l(89% and 64%). Response rate of vomiting was not significantly different between S-l and B-2 (85% and 90% in B-1 and B-2, respectively). Response rate of nausea, however, in B-2 was superior to that in B-l (48% and 63% in B-1 and B-2, respectivelyl. When the patients were asked for their opinion of the two regimen (A-1 or A-2 in group A and B-1 or B-2 in group E), 679; in group A and 1009o in group B prefered A-2 and B-2 regimens, respectively. There was no major side effects associated with antiemetic treatement. These results demonstrating that motilium suppository is cansiderably effective for low dose of 5-fluorouracil and cisplatin-induced emesis warrant a further trial to determine the optimal dose and schedule for clinical usage of Motilium suppository as antiemetics.
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