title: Olanzapine for the prevention of chemotherapy-induced nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy: a randomized, double-blind, placebo-controlled study.
abstract: BACKGROUND
  Chemotherapy-induced nausea and vomiting (CINV) can severely impair patients' quality of life (QOL). Psychotropics, especially olanzapine, have a strong antiemetic effect.
  
  
  OBJECTIVE
  To determine whether olanzapine could reduce the frequency of CINV and improve patients' QOL during chemotherapy.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled trial. Forty-four patients scheduled to receive highly or moderately emetogenic chemotherapy were enrolled. All patients received a 5-hydroxytryptamine3 receptor antagonist, steroid, and neurokinin-1 receptor antagonist. Patients were randomly assigned to take 5 mg/day of oral olanzapine (OL group, n = 22) or placebo (control group, n = 22) daily from the day before chemotherapy (Day 0) to Day 5. The primary endpoint was the rate of patients who achieved total control (no vomiting, no use of rescue medications, and maximum nausea of <5/100mm on a visual analogue scale). The secondary endpoint was Functional Living Index-Emesis questionnaire score on Days 0 and 6.
  
  
  RESULTS
  The rate of patients achieving total control was significantly higher in the OL group (86% and 64% in acute and delayed phases, respectively) than in the control group (55% and 23%, P = 0.045, P = 0.014, respectively). Furthermore, the OL group experienced a better QOL than the control group, as reported on the Functional Living Index-Emesis questionnaire (P = 0.0004).
  
  
  CONCLUSIONS
  The addition of 5mg/day of oral olanzapine to standard therapy can reduce the frequency of CINV and improve QOL of patients receiving highly or moderately emetogenic chemotherapy.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan. Electronic address: nao.nao910@aurora.ocn.ne.jp.
authors.forename: Naomi
authors.initials: N
authors.lastname: Mizukami
authors.affiliation: Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamauchi
authors.affiliation: Division of Palliative Medicine, Higashi-Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.affiliation: Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Urologic Surgery and Andrology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Ichihara
authors.affiliation: Department of Urologic Surgery and Andrology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Masumori
authors.affiliation: Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Yamakage
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage*; D004311:Double-Blind Method; D004435:Eating / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D064729:Neurokinin-1 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000077152:Olanzapine; D011619:Psychotropic Drugs / Q000008:administration & dosage; D011788:Quality of Life; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D064729:Neurokinin-1 Receptor Antagonists; D011619:Psychotropic Drugs; D058831:Serotonin 5-HT3 Receptor Antagonists; D013256:Steroids; D001569:Benzodiazepines; D000077152:Olanzapine
keywords: FLI-E; Olanzapine; appetite improvement; chemotherapy-induced nausea and vomiting; delayed emesis