A Randomized Comparison of Granisetron Plus Dexamethason with Granisetron alone for the Control of Acute Chemotherapy-Induced Emesis and Nausea

Introduction: chemotherapeutic drugs used to treat cancer may cause nausea and emesis by inducing the release of 5-hydroxytryptamine (5-ht) in the small intestine. blockage of 5-ht3 receptors in the small intestine by 5-ht3 receptor antagonists might prevent the nausea and vomiting associated with chemotherapy for cancer.the aim of this study was to compare the efficacy and tolerability of the 5-ht3 receptor antagonists (granisetron) and granisetron plus dexamethasone in the treatment of acute chemotherapy induced digestive emesis and nausea.materials and methods: patients on their first course of emetic chemotherapy (cisplation or doxorubicin based regimen) were randomly placed into two treatment groups. group a received a one-time administration of granisetron 3 mg, iv and group b received granisetron plus dexamethasone 8 mg iv. for each study the drugwere administered one time, 30 minutes before infusion of chemotherapy emetic agent. for the efficacy assessment, response data were recorded every 6 hours for a total of 24 hours, after the start of the chemotherapy infusion. results: a total of 138 patients [86 males, 52 females with amean age of 48 (a range between 15-82 years)]were involved in the study . of these, 125 were evaluable.discussion: the ability of granisetron plus dexamethason to prevent acute emesis was significantly better than, administering granisetron alone (66.7% vs 42.8% respectively) (p<0.001). the combination of granisetron and low-dose dexamethasone is superior to granisetron alone to control acute emetic episodes in patients receiving emetogenic chemotherapy.