Ramosetron for the prevention of nausea and vomiting during 5-fluorouracil-based chemoradiotherapy for pancreatico-biliary cancer.
OBJECTIVE
The aim of the study was to evaluate the role of ramosetron for the prevention of chemoradiotherapy-induced nausea and vomiting (CRINV) in patients receiving upper abdominal irradiation with concurrent 5-fluorouracil chemotherapy.


METHODS
Between November 2006 and April 2007, 25 patients with pancreatico-biliary cancer underwent adjuvant chemoradiotherapy. A total dose of 40 Gy was delivered using 2 Gy/fraction, 5 days a week, with 2 weeks of planned rest after 20 Gy. Concomitant 5-fluorouracil (500 mg/m(2)/day i.v. bolus) was administered for the first 3 days of each split course. During the first course of chemoradiotherapy, all patients had prophylactic metoclopramide before treatment and those refractory to metoclopramide received rescue medication with ondansetron. During the second course of chemoradiotherapy, prophylactic ramosetron was given to patients who were refractory to ondansetron. Response to antiemetics was scored in four tiers: none, no CRINV; mild, did not interfere with normal daily life; moderate, interfered with normal daily life and severe, patient bedridden because of CRINV.


RESULTS
Fifty-six percent of the patients (14 of 25) had moderate CRINV despite metoclopramide, and received ondansetron. Ten patients who experienced moderate CRINV despite the ondansetron had prophylactic ramosetron, and 60% of the patients (6 of 10) had the symptom improved.


CONCLUSIONS
Ramosetron proved to be an effective alternative for the control of CRINV during upper abdominal irradiation with concurrent 5-fluorouracil chemotherapy.
Kim
Kyubo
K
Department of Radiation Oncology, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul 110-744, Republic of Korea.
Chie
Eui Kyu
EK
Jang
Jin-Young
JY
Kim
Sun Whe
SW
Oh
Do-Youn
DY
Im
Seock-Ah
SA
Kim
Tae-You
TY
Bang
Yung-Jue
YJ
Ha
Sung W
SW
D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000503:physiopathology / Q000517:prevention & control*; D017294:Ondansetron / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D014839:Vomiting / Q000503:physiopathology / Q000517:prevention & control*
D000932:Antiemetics; D001562:Benzimidazoles; D017294:Ondansetron; C071315:ramosetron; D008787:Metoclopramide; D005472:Fluorouracil