Τίτλος:
Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Tsavaris, N.
Kosmas, C.
Kopterides, P.
Vadiaka, M.
Kosmas, N.
Skopelitis, H.
Karadima, D.
Kolliokosta, G.
Tzima, E.
Loukeris, D.
Pagouni, E.
Batziou, E.
Xyla, V.
Koufos, C.
Περιοδικό:
European Journal of Cancer Care
Λέξεις-κλειδιά:
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
DOI:
10.1111/j.1365-2354.2007.00829.x
