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

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. 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. 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. 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.