16 P Chemotherapy induced emesis. management of early and delayed emesis in milder emetogenic regimens

Abstract

The objective of the study was to examine the problem of control of nausea and vomiting induced by non-cisplatin cyclophosphamide-based chemotherapic regimens in breast cancer patients. This was a randomized double-blind, parallel-group and placebo controlled study comparing the efficacy of four antiemetic therapeutic regimens (A:Ondansetron for 3 days; B:Ondasetron plus Metoclopramide; C:Granisetron given a single dosis and D:Ondansetron given in a single dosis) in breast cancer patients receiving Cyclophosphamide, Methotrexate and 5-Fluoracil (CMF) regimen (174 cycles) and Cyclophosphamide, 4-Epiadryamicin and 5-Fluoracil (FEC) regimen (132 cycles). Both, number of emetic episodies (early and delayed emesis) and quality of life were evaluated. In patients receiving CMF there were no differences between regimens A, B and C in controlling early emesis. The single dose Ondansetron regimen (D) showed the worst resuts (p=0.003). Delayed emesis was best controlled by the “3 days-regimens” (A and B). In patients administered a FEC treatment, the antiemetic efficacy was superior for the single Granisetron regimen (C) if early emesis was considered. Moreover, efficacy of single Granisetron dosis (C) was similar to the 3-days Ondansetron regimen (A) in controlling delayed emesis after FEC treatment. The single Ondansetron regimen showed again the worst results (p=0.007). Despite different antiemetic schedules, nausea and emesis are significant problems in patients receiving cyclophosphamide-based chemotherapy.