title: The role of the 5-HT3 antagonists ondansetron and dolasetron in the control of delayed onset nausea and vomiting in patients receiving moderately emetogenic chemotherapy.
abstract: BACKGROUND
  5-HT3 antagonists are effective in reducing the acute nausea and vomiting caused by cancer chemotherapy. However, it is not clear whether continuing these agents beyond twenty four hours is useful in controlling emesis on days two to seven after chemotherapy.
  
  
  METHODS
  Four hundred seven patients receiving moderately emetogenic chemotherapy who had been given dexamethasone 8 mg i.v. and either ondansetron 32 mg i.v. or dolasetron 2.4 mg/kg i.v. were randomized to continue either an oral form of their 5-HT3 antagonist (ondansetron 8 mg b.i.d. or dolasetron 200 mg daily) plus dexamethasone 8 mg p.o. daily or dexamethasone alone for days two to seven. Endpoints assessed by self-report were: 1) complete control (no vomiting, no rescue medications, no missing data) of emesis; 2) nausea severity; and 3) quality-of-life as measured by the EORTC QLQ-C30.
  
  
  RESULTS
  Continuation of 5-HT3 antagonists improved slightly, but not significantly, the complete control rate (47% vs. 41%: P = 0.24 one-sided) after chemotherapy. However, mean nausea severity was significantly (P = 0.015 one sided) reduced (by 3 mm on a 10 cm scale) on the combined arm. Minimal differences in quality of life were observed.
  
  
  CONCLUSIONS
  The benefit of continuing 5-HT3 antagonists beyond 24 hours is modest and the merits of routine use in these circumstances debatable.
authors.affiliation: NCIC Clinical Trials Group, Queen's University, Kingston.
authors.forename: J L
authors.initials: JL
authors.lastname: Pater
authors.forename: W S
authors.initials: WS
authors.lastname: Lofters
authors.forename: B
authors.initials: B
authors.lastname: Zee
authors.forename: E
authors.initials: E
authors.lastname: Dempsey
authors.forename: D
authors.initials: D
authors.lastname: Walde
authors.forename: J P
authors.initials: JP
authors.lastname: Moquin
authors.forename: K
authors.initials: K
authors.lastname: Wilson
authors.forename: P
authors.initials: P
authors.lastname: Hoskins
authors.forename: R M
authors.initials: RM
authors.lastname: Guevin
authors.forename: S
authors.initials: S
authors.lastname: Verma
authors.forename: R
authors.initials: R
authors.lastname: Navari
authors.forename: J E
authors.initials: JE
authors.lastname: Krook
authors.forename: J
authors.initials: J
authors.lastname: Hainsworth
authors.forename: M
authors.initials: M
authors.lastname: Palmer
authors.forename: C
authors.initials: C
authors.lastname: Chin
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D017294:Ondansetron / Q000627:therapeutic use*; D011807:Quinolizines / Q000627:therapeutic use*; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*
chemical_list: D000932:Antiemetics; D007211:Indoles; D011807:Quinolizines; D012702:Serotonin Antagonists; D017294:Ondansetron; C060344:dolasetron