Acute and delayed emesis after cisplatin-based regimen: description and prevention.

Area of Science:

• Oncology
• Pharmacology
• Clinical Medicine

Background:

• Cisplatin chemotherapy frequently induces nausea and emesis.
• Delayed emesis can significantly impact patient quality of life.
• Effective antiemetic regimens are crucial for patient management during chemotherapy.

Purpose of the Study:

• To evaluate the efficacy and tolerability of a specific antiemetic regimen for preventing acute and delayed cisplatin-induced emesis.
• To assess the incidence and characteristics of delayed nausea and emesis.
• To discuss strategies for improving the prevention of delayed emetic events.

Main Methods:

• A combination of lorazepam, dexamethasone, and high-dose metoclopramide was administered on day 1 for acute emesis prevention.
• Prochlorperazine and dexamethasone were given on days 2 and 3 to control delayed emesis.
• Nausea and emesis were systematically recorded from day 1 to day 8 in 54 patients.

Main Results:

• Complete prevention of emesis on day 1 was achieved in 72% of patients, with 85% having satisfactory control (≤2 emeses).
• From days 2 to 8, 70% of patients experienced no emesis, while 11% and 19% had ≤2 and >2 episodes, respectively.
• Overall satisfactory control (days 1-8) was observed in 74% of patients. Delayed emesis occurred between days 2-5 and was more frequent if day 1 emesis occurred.

Conclusions:

• The combination regimen of lorazepam, dexamethasone, and metoclopramide demonstrated good tolerability and efficacy in preventing acute cisplatin-induced emesis.
• The study highlights the need for improved strategies to manage delayed nausea and emesis.
• Further research should systematically record delayed side effects to optimize antiemetic protocols.