Efficacy according to Dexamethasone Dose in Combination with Aprepitant and Granisetron during Cisplatin-based Chemotherapy

The purpose of this study was to evaluate the dosage of dexamethasone in combination with granisetron and aprepitant when used for the prevention of acute and delayed nausea and vomiting in patients receiving high-dose cisplatin chemotherapy. The study was retrospective. Ninety-two patients received cisplatin (≥50 mg/m 2 ) and either a high-dose (Group I, n=57) or low-dose (Group II, n=35) regimen of dexamethasone. The high-dose regimen consisted of intravenous administration of 20 mg on day 1 and 8 mg on days 2∼4. The low-dose regimen consisted of intravenous administration of 10 mg before cisplatin and oral dexamethasone 4 mg on days 2∼4. Both groups received granisetron and aprepitant. The primary endpoint was complete response over 5 days following cisplatin administration. In the acute phase, complete response occurred in 87.7% of Group I and 91.4% of Group II patients (p=0.58). In the delayed phase, the proportions of patients without emesis in Groups I and II were 84.2% and 65.7%, respectively (p=0.04). In the overall phase, the complete response rates in Groups I and II were 80.7% and 65.7%, respectively (p=0.11). The high-dose dexamethasone regimen is superior to the low-dose in preventing delayed chemotherapy-induced nausea and vomiting, with no significant differences evident in the acute and overall phases. The high-dose dexamethasone regimen should be considered as a standard antiemetic therapy for cisplatin-treated patients.