Antiemetic Effect of Granisetron plus Dexamethasone for the Patients Refractory to Metoclopramide , Dexamethasone and Lorazepam ( MDL )

Lee, Se Hoon; Kim, Dong Wan; Jung, Kyun Hae; Bang, Soo Mee; Byun, Jae Ho; Chang, Heung Moon; Heo, Dae Seog; Bang, Yung Jue; Kim, Noe Kyeong

Abstract

PURPOSE: The combination of dexamethasone and granisetron provides effective prophylaxis in patients treated with high-dose cisplatin. We performed this study to evaluate the antiemetic effect of granisetron plus dexamethasone for the patients refractory to metoclo- pramide, dexamethasone, lorazepam (MDL) regimen.
MATERIALS AND METHODS
From 1996 to 1998, we administered the MDL regimen in patients who received high-dose cisplatin (more than 60 mg/m/day) for the first time. The granisetron plus dexamethasone were administered in the subsequent cycle for the patients refractory to the MDL regimen during the first or the second cycle of chemotherapy. Efficacies of treatment were assessed daily from days 1 to 5. Complete response was defined as the absence of vomiting episodes and major response as 1 or 2 episodes per day. Complete or major responses were considered effective.
RESULTS
Twenty patients received granisetron plus dexamethasone therapy. During the first 24 hours, complete and major responses were achieved in 75% and 15% respectively, thus it was effective in 90% of patients. For delayed vomiting (occurring during days 2 through 5), complete and major responses were achieved in 30% and 50% respectively, thus it was effective in 80%. Side effects included hiccups, headache, diarrhea, sedation, dizziness and insomnia, but discontinuation or dose adjustment was not needed.
CONCLUSION
The granisetron plus dexamethasone regimen was an effective antiemetic regimen for the patients refractory to the MDL regimen.