title: A randomised trial of dexamethasone, lorazepam and prochlorperazine for emesis in patients receiving chemotherapy.
abstract: To define further the place of dexamethasone in antiemetic combinations, lorazepam, prochlorperazine and placebo (LP) were compared with lorazepam, prochlorperazine and dexamethasone (DLP) in a randomised, double-blind, crossover study. Both patient and observer assessments were documented in 84 patients receiving both cisplatin and non-cisplatin chemotherapy. The addition of dexamethasone significantly reduced the severity of nausea (P = 0.002) and vomiting (P less than 0.0001), duration of nausea (P = 0.01) and vomiting (P = 0.002) and the number of vomiting episodes (P = 0.003). DLP was the superior regimen in subsets of patients receiving cisplatin and the non-cisplatin chemotherapy. The improvements produced by the dexamethasone regimen were large and of major benefit to our patients. Patients documented significantly improved tolerance to chemotherapy with DLP courses (P = 0.0006). Overall, significantly more patients preferred DLP (P less than 0.0001). Patient assessments produced results similar to observer assessments but gave a broader understanding of their experience. The addition of dexamethasone to prochlorperazine and lorazepam significantly improved our patients' experience while receiving chemotherapy.
authors.affiliation: Department of Haematology & Medical Oncology, Peter MacCallum Cancer Institute, Melbourne, Vic., Australia.
authors.forename: J F
authors.initials: JF
authors.lastname: Bishop
authors.forename: J P
authors.initials: JP
authors.lastname: Matthews
authors.forename: M M
authors.initials: MM
authors.lastname: Wolf
authors.forename: I N
authors.initials: IN
authors.lastname: Oliver
authors.forename: S
authors.initials: S
authors.lastname: Reynolds
authors.forename: E
authors.initials: E
authors.lastname: Walpole
authors.forename: D
authors.initials: D
authors.lastname: Rischin
authors.forename: L
authors.initials: L
authors.lastname: Buchanan
authors.forename: L G
authors.initials: LG
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009369:Neoplasms / Q000188:drug therapy*; D011346:Prochlorperazine / Q000627:therapeutic use*; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000932:Antiemetics; D003907:Dexamethasone; D008140:Lorazepam; D002945:Cisplatin; D011346:Prochlorperazine