Pattern of carboplatin-induced emesis. The German Ondansetron Study Group.
In contrast to the broad experience concerning the therapeutic use of carboplatin, only limited data are available regarding the patterns of carboplatin-induced emesis, one of its most distressing side effects. This study reports frequency, severity and time course of carboplatin-induced vomiting and nausea refractory to 5-HT3 antagonism. A total of 216 patients receiving single-day carboplatin-based chemotherapy regimen were enrolled into an open multicenter study focusing on the safety and efficacy of ondansetron 8 mg t.d.s. Emesis on day 1 occurred in 22% and nausea in 75% of the patients; 44% of patients reported some degree of vomiting within the 5 days observation period. The risk for emesis and nausea over 2-5 days was increased in patients suffering from emesis on day 1 (relative risk 2.25 for vomiting and 2.84 for nausea, respectively). The median cumulative number of emetic episodes was 0 for all patients and 4 for the patients who did vomit at least on 1 day. Vomiting began on average 1.77 days following chemotherapy administration. The mean duration of vomiting was 2 days and 3.1 days for nausea. Carboplatin showed a monophasic prolonged pattern of emesis. The combination with cyclophosphamide led to an earlier onset and a higher frequency of vomiting. The analysis of the pattern of emesis refractory to 5-HT3 receptor blockade should help to describe the course of emesis, which is probably triggered through a 5-HT3 receptor-independent mechanisms.
du Bois
A
A
Frauenklinik, St Vincentius Krankenhäuser, Karlsruhe, Germany.
Vach
W
W
Cramer-Giraud
U
U
Thomssen
C
C
Glaubitz
M
M
Fiola
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000494:pharmacology; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000494:pharmacology; D016190:Carboplatin / Q000009:adverse effects* / Q000494:pharmacology; D002985:Clinical Protocols; D003520:Cyclophosphamide / Q000494:pharmacology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced* / Q000209:etiology; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D017294:Ondansetron / Q000494:pharmacology; D011985:Receptors, Serotonin / Q000187:drug effects; D044406:Receptors, Serotonin, 5-HT3; D012720:Severity of Illness Index; D014839:Vomiting / Q000139:chemically induced* / Q000209:etiology
D000932:Antiemetics; D000970:Antineoplastic Agents; D011985:Receptors, Serotonin; D044406:Receptors, Serotonin, 5-HT3; D017294:Ondansetron; D003520:Cyclophosphamide; D016190:Carboplatin