Combination antiemetic therapy in cisplatin-induced nausea and vomiting

Twenty-seven consecutive patients with advanced gynecologic malignancies undergoing chemotherapy with cisplatin in combination with other agents were studied in a prospective, randomized fashion to compare the antiemetic efficacy of a combination regimen with high-dose metoclopramide. The combination regimen consisted of prochlorperazine, dexamethasone, and pentobarbital. Patients treated with the combination regimen had significantly less vomitus (P less than 0.01, Student's t test) and fewer vomiting episodes (P less than 0.001, test for homogeneity) than patients treated with metoclopramide. In addition, the sedative and sleep-inducing effect of the barbiturate made the experience of vomiting more tolerable, even in those instances where the combination regimen was not superior to metoclopramide in the control of vomiting.