Preventive effect of Rikkunshito, a traditional Japanese medicine, on chemotherapy‐induced nausea and vomiting with cisplatin: Case series

Abstract

ABSTRACTAimSupportive therapies are important to treat chemotherapy‐induced nausea and vomiting (CINV). Rikkunshito, a Kampo medicine, has been reported to be effective against cisplatin‐induced anorexia in rats. In the present study, we evaluated the preventive effect of Rikkunshito for CINV in patients receiving high‐dose cisplatin chemotherapy.MethodsWe selected patients who received chemotherapy including cisplatin (≥60 mg/m2) for gastric or esophageal cancer between April 2010 and August 2012. We identified 20 patients treated without a reduction in the dose of anticancer medications during the second course and added 7.5 g/day Rikkunshito, which was orally administered, for 7 days. All patients were treated with 5‐hydroxytryptamine‐3 receptor antagonist, corticosteroid, and neurokinin‐1 receptor antagonist for the prevention of CINV during the first and second courses. We evaluated complete response (CR; defined as no emesis and no rescue medication) and other toxicities according to the Common Terminology Criteria for Adverse Events version 4.0.ResultsThe median patient age was 63 years (range, 49–77 years). The chemotherapy regimens used were cisplatin plus 5‐fluorouracil in 15 patients with esophageal cancer and cisplatin plus S‐1 in five patients with gastric cancer. Rate of delayed CR was 75.0% during the first course (95% CI: 56.0–94.0%), which improved during the second course to 95.0% (95% CI: 85.4–100%, P = 0.077). There was no significant difference in other major toxicities between the first and second courses.ConclusionRikkunshito has the potential to alleviate CINV in patients receiving high‐dose cisplatin chemotherapy.