A Randomized, Double Blinded Comparison of Single Dose Ondansetron and Metoclopramide Plus Dexamethasone in The Prevention of Single Agent Carboplatin Induced Emesis in Ovarian and Endometrial Carcinoma

Abstract

Objective To compare the efficacy of ondansetron and metoclopramide plus dexamethasone in
preventing emesis induced by single agent carboplatin within 24 hours.
Design Randomized, double-blinded, crossover trial.
Settings Gynecologic Oncology unit at King Chulalongkorn Memorial Hospital.
Patients Patients with ovarian and endometrial carcinoma being treated in gynecologic on
cology unit with postoperative adjuvant carboplatin. Of 72 patients, 67 patients were evaluated
for crossover analysis, 5 were excluded due to failure to get the second crossover-courses. (3
patients-loss to follow up, 2 patients-discontinued chemotherapy because of progressive
disease, another with wrong pathological report (borderline mucinous cystadenoma)
Interventions All patients received carboplatin 350mg/m2 body surface area and ondansetron 8 mg
or metoclopramide 20 mg plus dexamethasone 20 mg in a crossover style. Both antiemetic
regimens were given intravenously 30 minutes prior to carboplatin infusion.
Measurements and main results Within 24 hours after receiving carboplatin, complete control
was seen in 67.1% of the ondansetron-treated patients and 43.5% of the metoclopramide
and dexamethasone-treated patients (P<0.05), major control was seen in 81.4% of the
ondansetron-treated patients and 68.1% of the metoclopramide and dexamethasone-treated
patients. (P>0.05)
Conclusions Single dose ondansetron was more effective than metoclopramide plus dexamethasone in preventing acute emesis induced by single agent carboplatin. The emetic control was
less if ondansetron was given on second cycle.