Side effects associated with the use of dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy.
The role of dexamethasone to reduce delayed emesis following highly emetogenic chemotherapy is proven, but there is less evidence of benefit after mild-moderately emetogenic regimens. Here, we develop and evaluate a Dexamethasone Symptom Questionnaire (DSQ) to assess the side effects of dexamethasone in the week after patients receive moderately emetogenic chemotherapy. The DSQ was first optimised with the aid of a focus group. Sixty patients receiving oral dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy for cancer completed and then evaluated the DSQ. Patients reported that the DSQ was clearly worded and addressed items important to them. Patients receiving dexamethasone reported moderate-severe problems with insomnia (45%), indigestion/epigastric discomfort (27%), agitation (27%), increased appetite (19%), weight gain (16%) and acne (15%) in the week following chemotherapy. The side effects of dexamethasone may outweigh its benefits when used with moderately emetogenic chemotherapy. A randomised, double-blind crossover trial is underway to determine the effect of dexamethasone on nausea and vomiting, and the impact of side effects of dexamethasone and of nausea and vomiting on quality of life.
Department of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, 610 University Ave, Toronto, Ontario, Canada M5G2M9.
J
J
Vardy
K S
KS
Chiew
J
J
Galica
G R
GR
Pond
I F
IF
Tannock
D000152:Acne Vulgaris / Q000139:chemically induced; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000009:adverse effects* / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D010146:Pain / Q000139:chemically induced; D011594:Psychometrics; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D011795:Surveys and Questionnaires; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D015430:Weight Gain
D000932:Antiemetics; D003907:Dexamethasone