Comparison of Antiemetic Effects of Ondansetron Granisetron and Tropisetron For Acute Emesis In Ovarian Cancer Patients Receiving Chemotherapy With Paclitaxel and Carboplatin

Taner TURAN, Serap BOZOK, Nihal ERDOĞAN, Özlem KARAÇAY, Gökhan TULUNAY, Nurettin BORAN İskender KÖG, M. Faruk KÖSE

Ankara, Turkey

OBJECTIVE: Emesis is a critical adverse effect of cancer treatment. In this study, prophylactic activity of ondansetron (OND), tropisetron (TRO) and granisetron (GRA) on acute emesis following carboplatinpaclitaxel chemotherapy was compared.
STUDY DESIGN: Charts of 277 patients, who had been treated with first-line carboplatin-paclitaxel combined chemotherapy after being operated with a diagnosis of gynecologic malignancy in between 1993 and 2005, were evaluated retrospectively. After premedication, chemotherapy was initiated with paclitaxel 175 mg/m², infused in three hours. Then, carboplatin was infused in one hour (AUC=6). 90 minutes before the onset of chemotherapy, dexamethasone, 24 mg was infused within an hour. 5 HT3 receptor antagonist (OND=8 mg / TRO=5 mg / GRA=3 mg) were infused for a duration of 30 minutes, one hour before the chemotherapy. Toxicity was evaluated according to WHO criteria. Grade 0 toxicity was accepted as complete response, grade 1 and higher toxicity was accepted unresponsive.
RESULTS: The mean age was 55 years. Overall 1582 courses of chemotherapy were given. 241 patients (87%) received six courses. OND was given to 57 (20.6%) patients at 321 (20.3%) courses, TRO to 57 (20.6%) patients at 330 (20.9%) courses and GRA to 163 (58.8%) patients at 931 (58.8%) courses. Grade 3-4 toxicity did not develop in any of the patients. Complete response was achieved in 41.2% of the patients in 77.1% of the cycles. Antiemetic activities of TRO and GRA were stronger than OND.
CONCLUSION: Even though this study was retrospective, the treatment and patient groups were homogeneous. Both the discovery of an antiemetic that is much more effective and a protocol that is improved are essential. An emerging need for prospective studies achieved with homogeneous patient groups does exist.
(Gynecol Obstet Reprod Med; 13:2 107-111)
Key Words: Carboplatin, Emesis, 5 HT3 receptor antagonists