@article{3132274,
    title = "Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes",
    author = "Tsavaris, N. and Kosmas, C. and Kopterides, P. and Vadiaka, M. and Kosmas, N. and Skopelitis, H. and Karadima, D. and Kolliokosta, G. and Tzima, E. and Loukeris, D. and Pagouni, E. and Batziou, E. and Xyla, V. and Koufos, C.",
    journal = "European Journal of Cancer Care",
    year = "2008",
    volume = "17",
    number = "2",
    pages = "167-173",
    issn = "0961-5423, 1365-2354",
    doi = "10.1111/j.1365-2354.2007.00829.x",
    keywords = "alprazolam;  antiemetic agent;  antineoplastic agent;  carboplatin;  dexamethasone;  indole derivative;  taxoid;  tropisetron, adjuvant chemotherapy;  aged;  article;  comparative study;  female;  human;  lung non small cell cancer;  lung tumor;  male;  mental stress;  middle aged;  treatment outcome;  vomiting, Aged;  Alprazolam;  Antiemetics;  Antineoplastic Combined Chemotherapy Protocols;  Carboplatin;  Carcinoma, Non-Small-Cell Lung;  Chemotherapy, Adjuvant;  Dexamethasone;  Female;  Humans;  Indoles;  Lung Neoplasms;  Male;  Middle Aged;  Stress, Psychological;  Taxoids;  Treatment Outcome;  Vomiting",
    abstract = "Even though significant progress has been made, chemotherapy-induced emesis remains a challenging problem. Few studies focus on emesis in patients treated with carboplatin and the observation period is limited to the initial 24 h following chemotherapy. Thus, we investigated if tropisetron (T) monotherapy can adequately prevent acute and delayed emesis in non-small-cell lung cancer (NSCLC) patients receiving a moderately emetogenic chemotherapy (MEC) (carboplatin-containing) regimen. Furthermore, we explored the merits of adding dexamethasone (D) or alprazolam (A) to T, especially in the setting of a pre-existing high level of stress. We studied 60 patients with advanced NSCLC receiving carboplatin and taxanes in three consecutive cycles. During the first cycle, patients received 5 mg of T intravenously before chemotherapy and the same dose per os on each of the following 3 days. In the second cycle, T was co-administered with 8 mg of D once a day, while, during the third cycle, T was combined with per os A 0.25 mg every 12 h and continued over the following 3 days. Finally, we evaluated the impact of stress on the anti-emetic response achieved with the previously described regimens. The combination of T + A was superior to T monotherapy and the combination of T + D, regarding the prevention of acute and delayed emesis. Both T + A and T + D combinations led to appetite improvement, while patients receiving T + A experienced sedation more frequently. Interestingly, subgroup analysis revealed that patients without underlying stress obtained no further benefit by the addition of A or D, while both T + A and T + D combinations led to a better anti-emetic response in patients with stress. In conclusion, T monotherapy provides a satisfactory result in controlling nausea and emesis caused by a MEC regimen in patients without stress. However, the addition of D and, mainly, A improves its anti-emetic effect in patients with obvious stress. © 2007 Blackwell Publishing Ltd."
}