Comparison of Oral versus Intravenous Ramosetron in Prevention of Acute Cisplatin-Induced Emesis :A Ran domized Controlled Trial
CHARUWAN TANTIPALAKORN,MD*, JATUPOL SRISOMBOON, MD*, HUNS A THIENTHONG, MSc**, AREE PANTUSART, BSc*, PRAPAPORN SUPRASERT, MD*, CHANRAM SAEREESONGKHUN, BSc**, SAISUNEE EAMTA NG, BSc**, AMPHIKA SUTTHICHAT, BSc**, NUTHA Y A PA UT AD, BSc**
Affiliation : * Department of Obstetrics & Gynecology, Faculty of Medicine, Chiang Mai University, ** Division of Nursing, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai 50200, Thailand.
Objective : To compare the antiemetic efficacy of a single oral versus intravenous (IV) ramosetron, a new class of selective 5-HT receptor antagonists, in gynecologic cancer patients receiving 3 high-dose cisplatin.
Method : Between February 2003 and July 2003, 109 patients with gynecologic cancer sche duled to receive single agent cisplatin chemotherapy at a dose of 75 mg/m2 were randomized to receive either 0.2 mg oral (51 cases) or 0.3 mg IV (58 cases) ramosetron 1 hand 30 min respectively before chemotherapy. Patients were evaluated for 24 h after chemotherapy. The number of nausea and vomit ing including adverse events were recorded every 6 h.
Results : 51 and 58 patients received oral and IV ramosetron respectively. Both groups were similar regarding age, performance status, body mass index and diagnosis of gynecologic cancer. 95 per cent of cases were cervical cancer. Antiemetic effect was significantly higher in the oral group when compared with the IV group during the first 6 hours and during the period of 18 to 24 hours after administration of cisplatin chemotherapy. Overall in 24 h, patients receiving oral ramosetron = experienced no emesis slightly higher than that of the IV group (55% and 36% respectively, p 0.05). Adverse events were mild and transient and were not significantly different in both groups, except tiredness which was more frequent in the IV group.
Conclusion : Oral ramosetron at a dosage of 0.2 mg is as effective as 0.3 mg of intravenous ramosetron in prevention of acute emesis in patients receiving 75 mg/m2 of cisplatin chemotherapy.
Keywords : Ramosetron, Cisplatin, Chemotherapy, Antiemesis
