Cisplation 병용 항암화학요법시 Ondansetron 과 Dexamethasone 의 오심과 구토에 대한 예방효과 |
편욱범, 김성남, 정성애, 이순남 |
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Anti - Emetic Effect of Ondansetron Combined with Dexamethasone in Cisplatin Induced Nausea and Vomiting |
Wook Bum Pyun, Seong Nam Kim, Sung Ae Jung, Soon Nam Lee |
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ABSTRACT |
Cisplatin, an agent highly effective against a variety of cancers, produces the most severe nausea and vomiting of any chemotherapeutic agents. Recently, the role of 5-HT,(serotonin) in cisplatin induced nausea and vomiting was introduced and ondansetron a selective 5-HT, receptor antagonist, was administered to prevent cisplatin induced nausea and vomiting. Remarkable effects on acute emesis was obtained but effects on delayed emesis was not controlled by ondansetron only. This study was done to investigate the effectiveness and side effects of ondsnsetron combined with dexamethasone in cisplatin induced nausea and vomitiog. To evaluate the effetiveness of ondansetron combined with dexamethasone in preventing cisplatin induced nause and vomiting, 16 cancer patients who were treated with intravenous cisplatin containing chemotherapy as the first anticancer therapy were administered 20 mg dexamethasone i.v. 20 minutes before and 8 mg ondansetron i.v. 15 minutes before, 4 hour and 8 hour after ciaplatin infusion respectively on day 1, and 8 mg ondansetron was administered orally three times a day on day 2-4. On the first day, the complete response and major response were noted in 75%(12/16 patients), and 19%(3/l6 patients) respectively, minor response in 6%(l/16 patients), and none showed failure. On the second day, the complete response and major response were noted in 44 %(7/16 patients) and 25%(4/16 Patients) respectively, minor response in 19%(3/16 patients), and 12%(2/16 patients) showed failure. On the third to fourth day, complete response was noted in 29%(4/14 patients), major response 29%(4/14 patients), and minor response and failure were noted in 21%(3/l4 patientsl respectively. Two patients complained headache, dizziness respectively and the other two patients complained abdominal pain and diarrhea, but the degree was mild and subsided by conservative management. With these results, the administration of ondansetron and dexamethasone to prevent the cisplatin induced nausea and vomiting was effective for acute emesis but not so effective in delayed emesis even with combination of dexamethasone. Further study would be necessary to overcome the low effectiveness on the control of delayed emesis. |
Key words:
Ondansetren, Dexamethasone, Antiemetic effect |
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