Can granisetron injection used as primary prophylaxis improve the control of
nausea and vomiting with low- emetogenic chemotherapy?
Author(s): Keat CH(1), Phua G, Abdul Kassim MS, Poh WK, Sriraman M.
Affiliation(s): Author information:
(1)Department of Pharmacy, Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia.
huankeat123@yahoo.com
Publication date & source: 2013, Asian Pac J Cancer Prev. , 14(1):469-73
BACKGROUND: The purpose of this study is to examine the risk of uncontrolled
chemotherapy-induced nausea and vomiting (CINV) among patients receiving low
emetogenic chemotherapy (LEC) with and without granisetron injection as the
primary prophylaxis in addition to dexamethasone and metochlopramide.
MATERIALS AND METHODS: This was a single-centre, prospective cohort study. A
total of 96 patients receiving LEC (52 with and 42 without granisetron) were
randomly selected from the full patient list generated using the e-Hospital
Information System (e-His). The rates of complete control (no CINV from days 1 to
5) and complete response (no nausea or vomiting in both acute and delayed phases)
were identified through patient diaries which were adapted from the MASCC
Antiemesis Tool (MAT). Selected covariates including gender, age, active alcohol
consumption, morning sickness and previous chemotherapy history were controlled
using the multiple logistic regression analyses.
RESULTS: Both groups showed significant difference with LEC regimens (p<0.001).
No differences were found in age, gender, ethnic group and other baseline
characteristics. The granisetron group indicated a higher complete response rate
in acute emesis (adjusted OR: 0.1; 95%CI 0.02-0.85; p=0.034) than did the
non-granisetron group. Both groups showed similar complete control and complete
response rates for acute nausea, delayed nausea and delayed emesis.
CONCLUSIONS: Granisetron injection used as the primary prophylaxis in LEC
demonstrated limited roles in CINV control. Optimization of the
guideline-recommended antiemetic regimens may serve as a less costly alternative
to protect patients from uncontrolled acute emesis.
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