TY - JOUR
TI - Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes
AU - Tsavaris, N.
AU - Kosmas, C.
AU - Kopterides, P.
AU - Vadiaka, M.
AU - Kosmas, N.
AU - Skopelitis, H.
AU - Karadima, D.
AU - Kolliokosta, G.
AU - Tzima, E.
AU - Loukeris, D.
AU - Pagouni, E.
AU - Batziou, E.
AU - Xyla, V.
AU - Koufos, C.
JO - European Journal of Cancer Care
PY - 2008
VL - 17
TODO - 2
SP - 167-173
PB - 
SN - 0961-5423, 1365-2354
TODO - 10.1111/j.1365-2354.2007.00829.x
TODO - 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
TODO - 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.
ER -