A Randomized Comparison of Granisetron Plus Dexamethason with Granisetron alone for the Control of Acute Chemotherapy-Induced Emesis and Nausea

Introduction: Chemotherapeutic drugs used to treat cancer may cause nausea and emesis by inducing the release of 5-hydroxytryptamine (5-HT) in the small intestine. Blockage of 5-HT3 receptors in the small intestine by 5-HT3 receptor antagonists might prevent the nausea and vomiting associated with chemotherapy for cancer. The aim of this study was to compare the efficacy and tolerability of the 5-HT3 receptor antagonists (granisetron) and granisetron plus dexamethasone in the treatment of acute chemotherapy induced digestive emesis and nausea. Materials and Methods: Patients on their first course of emetic chemotherapy (cisplation or doxorubicin based regimen) were randomly placed into two treatment groups. Group A received a one-time administration of granisetron 3 mg, IV and group B received granisetron plus dexamethasone 8 mg IV. For each study the drug were administered one time, 30 minutes before infusion of chemotherapy emetic agent. For the efficacy assessment, response data were recorded every 6 hours for a total of 24 hours, after the start of the chemotherapy infusion. Results: A total of 138 patients [86 males, 52 females with amean age of 48 (a range between 15-82 years)] were involved in the study . Of these, 125 were evaluable. Discussion: The ability of granisetron plus dexamethason to prevent acute emesis was significantly better than, administering granisetron alone (66.7% vs 42.8% respectively) (p 0.001). The combination of granisetron and low-dose dexamethasone is superior to granisetron alone to control acute emetic episodes in patients receiving emetogenic chemotherapy.