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Antiemetics in children receiving cancer chemotherapy: a double-blind prospective randomized study comparing
Insights
Chlorpromazine (CLP) is more effective than metoclopramide (MCP) in managing chemotherapy-induced nausea and vomiting in pediatric cancer patients. CLP reduced vomiting frequency and duration, with fewer side effects than MCP.
Area of Science:
- Pediatric Oncology
- Clinical Pharmacology
- Pharmacology
Background:
- Chemotherapy-induced nausea and vomiting (CINV) significantly impacts children's quality of life.
- Limited comparative data exists for antiemetic efficacy in pediatric cancer patients.
Purpose of the Study:
- To prospectively compare the efficacy and safety of metoclopramide (MCP) and chlorpromazine (CLP) as antiemetics in children undergoing chemotherapy.
Main Methods:
- A prospective randomized study involving 50 pediatric cancer patients (aged 6-18 years) receiving emetogenic chemotherapy.
- Patients were randomized to receive either conventional doses of MCP or CLP.
- Outcomes measured included vomiting frequency, duration of nausea and vomiting, and extrapyramidal reactions (EPRs).
Main Results:
- Chlorpromazine (CLP) demonstrated significantly greater efficacy in reducing the frequency of vomiting (P < .05) and the duration of nausea and vomiting (P < .025) compared to metoclopramide (MCP).
- Extrapyramidal reactions (EPRs) were more frequently observed in the MCP-treated group.
Conclusions:
- Chlorpromazine (CLP) is a more effective antiemetic than metoclopramide (MCP) for pediatric patients receiving intensive chemotherapy at standard doses.
- Further research into antiemetic combinations for pediatric CINV is warranted.
Abstract:
This is the first prospective randomized study comparing commonly used antiemetics in children receiving cancer chemotherapy. We compared metoclopramide (MCP) with chlorpromazine (CLP), both administered in conventional doses, in 50 cancer patients aged 6 to 18 years who were receiving emetic chemotherapy. CLP proved significantly better than MCP in reducing both the frequency of vomiting (P less than .05) and the duration of nausea and vomiting (P less than .025). Extrapyramidal reactions (EPRs) were more common in MCP-treated patients. We conclude that, in the standard doses used, CLP is a better overall antiemetic than MCP for children receiving intensive chemotherapy. However, further prospective pediatric studies of antiemetic combinations are needed.