Combination of palonosetron-dexamethasone is more effective than ondansetron-dexamethasone as single cisplatin antiemetic chemotherapy
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Objective: To know the efficacy differences between two groups of drug combination ondansetron-dexamethasone (A) and ondan-setron-dexamethasone (B) to prevent emetic rsponses after chemotherapy cisplatin administration (CINV).
Materials and Methods: A prospective double blind randomized clinical trial study held in Dr. Soetomo General Hospital involving 66 subjects, devide into two groups randomly 33 patients each. One group receive palonosetron-dexamethasone combination therapy compare to ondansetron-dexamethasone combination as standart therapy in gynecologic oncology Dr. Soetomo Hospital in a control group as cisplatin chemotharapy CINV prophylaxis. The research was conducted from June till October 2014 in the Dr. Soetomo General Hospital-Surabaya. Assessment and measurement of the response of nausea and frequency of vomiting according Gralla scale, changes in plasma density and electrolyte serum (Na, K, and Cl) as a result of dehydration caused by nausea and vomiting, as well as counting the onset of nausea and vomiting occur.
Results: There was significant differences between the results of the combination therapy compared ondansetron-dexamethasone to palonosetron-dexamethasone for nausea and vomiting (p=0,001). 31 subjects suffers nausea in ondansetron group, while 9 subjects suffers nausea in palonosetron group. Vomiting occurs in 17 subjects from ondansetron group, and only 1 subject from palono-setron group during study. Changes in plasma density significant in palonosetron group, and natrium in ondansetron group. For K and Cl not significantly difference in both groups before and after cisplatin chemotherapy administration.
Conclusion: Palonosetron-dexamethasone combination is super-ior as cisplatin CINV prophylaxis in response to nausea and vomiting frequency, and also give longer protection compare to ondansetron-dexamethasone significantly. The plasma density and electrolyte serum changes are varied in numbers and also influenced by many factors including physical status and nutrition, also intake of each patients.Saleh A. Kemoterapi. In: Aziz MF, Andrijono, Saifuddin AB (eds). Buku Ajar Ginekologi. Jakarta: Yayasan Bina Pustaka Sarwono Prawirohardjo; 2006. p. 359-84.
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