title: Chlorpromazine and dexamethasone versus high-dose metoclopramide and dexamethasone in patients receiving cancer chemotherapy, particularly cis-platinum: a prospective randomized crossover study.
abstract: Sixty-nine patients with malignant tumors receiving cancer chemotherapy, 90% including cis-platinum, were evaluated in a randomized crossover study for the antiemetic efficacy and the side effects of two antiemetic regimens: chlorpromazine (CPM) 2.5 mg/kg in 5 doses plus dexamethasone (DXM) 0.2 mg/kg in 2 doses, and high-dose metoclopramide (HD-MCP) 10 mg/kg in 5 doses plus the same dose of DXM. In 69% of 173 courses of chemotherapy, antiemetic response was achieved, and in 26% emesis was completely prevented. There was no statistical difference in the response to the antiemetic regimens, but 65% of the patients who completed 3 courses of chemotherapy preferred HD-MCP plus DXM. The main side effects of the treatment were drowsiness, nervousness, diarrhea and extrapyramidal reactions. HD-MCP plus DXM is recommended as a first line antiemetic treatment in patients receiving cancer chemotherapy. Patients resistant to this treatment should receive CPM plus DXM treatment.
authors.affiliation: Department of Oncology, Sharett Institute, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Gez
authors.forename: R
authors.initials: R
authors.lastname: Ben-Yosef
authors.forename: R
authors.initials: R
authors.lastname: Catane
authors.forename: G
authors.initials: G
authors.lastname: Brufman
authors.forename: S
authors.initials: S
authors.lastname: Biran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000932:Antiemetics; D002746:Chlorpromazine / Q000008:administration & dosage* / Q000627:therapeutic use; D002945:Cisplatin / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D003907:Dexamethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies; D011897:Random Allocation; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D003907:Dexamethasone; D008787:Metoclopramide; D002945:Cisplatin; D002746:Chlorpromazine