A double-blind, crossover, randomized dose-comparison trial of granisetron for the prevention of acute and delayed nausea and emesis in children receiving moderately emetogenic carboplatin-based chemotherapy.
BACKGROUND
Granisetron is a safe and effective prophylaxis for nausea and vomiting associated with moderate to highly emetogenic chemotherapy. Few trials have been conducted to determine the optimal effective dose of granisetron in children with cancer. The objective of this report was to compare two doses of granisetron in patients with optic pathway tumors receiving moderately emetogenic doses of carboplatin.


METHODS
In this double-blind, crossover, randomized study, antiemetic efficacy and tolerability of two dose levels (10 and 40 microg/kg) of granisetron in the prevention of acute and delayed nausea/emesis were compared in children and young adults. A total of 18 patients (13 boys) aged 1-23 years (median 7.7 years) treated with a moderately emetogenic dose of carboplatin were randomly assigned to receive either 10 or 40 microg/kg of slow granisetron intravenous (i.v.) infusions at alternating cycles of chemotherapy in a blinded fashion until the end of the study period or until their chemotherapy regimen ended. In this way, the patients acted as their own controls.


RESULTS
Patients in the granisetron 10 and 40 microg/kg groups received 104 and 121 cycles of chemotherapy, respectively. There was no significant difference in antiemetic efficacy in terms of nausea and emesis between the dose groups in the first 5 days of chemotherapy. The treatment was well tolerated.


CONCLUSIONS
We conclude that granisetron 10 and 40 microg/kg have comparable efficacy in controlling carboplatin-induced acute and delayed nausea/emesis and is well tolerated in children and young adults.
Berrak
Su G
SG
Pediatric Hematology Oncology, Marmara University Medical Center, Altunizade, Istanbul, Turkey. sberrak@yahoo.com
Ozdemir
Nihal
N
Bakirci
Nadi
N
Turkkan
Emine
E
Canpolat
Cengiz
C
Beker
Bahar
B
Yoruk
Asim
A
D000293:Adolescent; D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage* / Q000494:pharmacology; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016190:Carboplatin / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004309:Double Bind Interaction; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D017829:Granisetron / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007223:Infant; D008297:Male; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*
D000932:Antiemetics; D000970:Antineoplastic Agents; D016190:Carboplatin; D017829:Granisetron