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01-09-2013 | Review

Timing and duration of 5-HT₃ receptor antagonist therapy for the prophylaxis of radiotherapy-induced nausea and vomiting: a systematic review of randomized and non-randomized studies

Authors: Kristopher Dennis, Leila Makhani, Ernesto Maranzano, Petra Feyer, Liang Zeng, Carlo De Angelis, Lori Holden, C. Shun Wong, Edward Chow

Published in: Journal of Radiation Oncology | Issue 3/2013

Abstract

Introduction

5-HT₃ receptor antagonists (5-HT₃RAs) are the most commonly recommended agents for the prophylaxis of radiotherapy-induced nausea and vomiting (RINV) within international antiemetic guidelines. However, the optimal timing and duration of their administration is unknown. We reviewed the relevant literature as a first step in addressing this important issue in supportive care.

Methods

EMBASE and EMBASE Classic, Ovid MEDLINE, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were searched for articles reporting on patient cohorts receiving prophylactic therapy with a 5-HT₃RA and being prospectively evaluated for RINV. Cohorts were grouped into high-, moderate-, and low-emetic-risk categories according to international guidelines.

Results

The search identified 599 references, and 25 were included in the review. These contained 33 discrete patient cohorts (cumulative n = 1,067) that were prospectively evaluated for RINV while receiving prophylactic 5-HT₃RA therapy. Of the 11 high-emetic-risk radiotherapy cohorts, two, eight, and one received 5-HT₃RAs for durations longer than, equal to, or shorter than the duration of radiotherapy, respectively. Of the 22 moderate or low-emetic-risk radiotherapy cohorts, 5, 14, and 3 received 5-HT₃RAs for durations longer than, equal to, or shorter than the duration of radiotherapy, respectively. Radiotherapy regimens and study endpoints were heterogeneous, precluding statistical comparisons of prophylaxis strategies.

Conclusion

5-HT₃RAs were most commonly administered for the entire duration of a course of radiotherapy. Future studies should compare different timings and durations of therapy with common efficacy endpoints to develop effective and cost-efficient antiemetic strategies.

Feyer PC, Maranzano E, Molassiotis A, Roila F, Clark-Snow RA, Jordan K (2011) Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009. Support Care Cancer 19(Suppl 1):S5–S14PubMedCrossRef

Enblom A, Bergius AB, Steineck G, Hammar M, Borjeson S (2009) One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient. Support Care Cancer 17(1):23–32PubMedCrossRef

The Italian Group for Antiemetic Research in Radiotherapy (1999) Radiation-induced emesis: a prospective observational multicenter Italian trial. Int J Radiat Oncol Biol Phys 44(3):619–625CrossRef

Maranzano E, De Angelis V, Pergolizzi S et al (2010) A prospective observational trial on emesis in radiotherapy: analysis of 1020 patients recruited in 45 Italian radiation oncology centres. Radiother Oncol 94:36–41PubMedCrossRef

Basch E, Prestrud AA, Hesketh PJ et al (2011) Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 29(31):4189–4198PubMedCrossRef

National Comprehensive Cancer Network (2011) Clinical practice guidelines in oncology. Antiemesis. V.3.2011. http://www.nccn.org/clinical.asp. Accessed 12 December 2011

Bermudez J, Boyle EA, Miner WD, Sanger GJ (1988) The anti-emetic potential of the 5-hydroxytryptamine3 receptor antagonist BRL 43694. Br J Cancer 58:644–650PubMedCrossRef

Tramer MR, Reynolds DJM, Stoner NS, Moore RA, McQuay HJ (1998) Efficacy of 5-HT3 receptor antagonists in radiotherapy-induced nausea and vomiting: a quantitative systematic review. Eur J Cancer 34(12):1836–1844PubMedCrossRef

de Wit R, Aapro M, Blower PR (2005) Is there a pharmacological basis for differences in 5-HT3-receptor antagonist efficacy in refractory patients? Cancer Chemother Pharmacol 56:231–238PubMedCrossRef

10.

Scarantino CW, Ornitz RD, Hoffman LG, Anderson RF (1994) On the mechanism of radiation-induced emesis: the role of serotonin. Int J Radiat Oncol Biol Phys 30(4):825–830PubMedCrossRef

11.

Yamamoto K, Takeda N, Yamatodani A (2002) Establishment of an animal model for radiation-induced vomiting in rats using pica. J Radiat Res 43:135–141PubMedCrossRef

12.

Olver I, Molassiotis A, Aapro M, Herrstedt J, Grunberg S, Morrow G (2011) Antiemetic research: future directions. Support Care Cancer 19(Suppl 1):S49–S55PubMedCrossRef

13.

Spitzer TR, Bryson JC, Cirenza E et al (1994) Randomized double-blind, placebo-controlled evaluation of oral Ondansetron in the prevention of nausea and vomiting associated with fractionated total-body irradiation. J Clin Oncol 12:2432–2438PubMed

14.

Spitzer TR, Friedman CJ, Bushnell W, Frankel SR, Raschko J (2000) Double-blind, randomized, parallel-group study on the efficacy and safety of oral Granisetron and oral Ondansetron in the prophylaxis of nausea and vomiting in patients receiving hyperfractionated total body irradiation. Bone Marrow Transplant 26:203–210PubMedCrossRef

15.

Belkacemi Y, Ozsahin M, Pene Francoise P et al (1996) Total body irradiation prior to bone marrow transplantation: efficacy and safety of Granisetron in the prophylaxis and control of radiation-induced emesis. Int J Radiat Oncol Biol Phys 36(1):77–82PubMedCrossRef

16.

Tiley C, Powles R, Catalano J et al (1992) Results of a double blind placebo controlled study of ondansetron as an antiemetic during total body irradiation in patients undergoing bone marrow transplantation. Leuk Lymphoma 7:317–321PubMedCrossRef

17.

Franzen L, Nyman J, Hagberg H et al (1996) A randomised placebo controlled study with Ondansetron in patients undergoing fractionated radiotherapy. Ann Oncol 7:587–592PubMedCrossRef

18.

Henriksson R, Lomberg H, Israelsson G, Zackrisson B, Franzen L (1992) The effect of ondansetron on radiation-induced emesis and diarrhoea. Acta Oncol 31(7):767–769PubMedCrossRef

19.

Priestman TJ, Roberts JT, Lucraft H et al (1990) Results of a randomized double-blind comparative study of ondansetron and metoclopramide in the prevention of nausea and vomiting following high-dose upper abdominal irradiation. Clin Oncol (R Coll Radiol) 2:71–75CrossRef

20.

Priestman TJ, Roberts JT, Upadhyaya BK (1993) A prospective randomized double-blind trial comparing ondansetron versus prochlorperazine for the prevention of nausea and vomiting in patients undergoing fractionated radiotherapy. Clin Oncol (R Coll Radiol) 5:358–363CrossRef

21.

Sykes AJ, Kiltie AE, Stewart AL (1997) Ondansetron versus a chlorpromazine and dexamethasone combination for the prevention of nausea and vomiting: a prospective, randomised study to assess efficacy, cost effectiveness and quality of life following single-fraction radiotherapy. Support Care Cancer 5:500–503PubMedCrossRef

22.

Bey P, Wilkinson PM, Resbent M et al (1996) A double-blind, placebo-controlled trial of i.v. dolasetron mesilate in the prevention of radiotherapy-induced nausea and vomiting in cancer patients. Support Care Cancer 4:378–383PubMedCrossRef

23.

Bodis S, Alexander E, Kooy H, Loeffler JS (1994) The prevention of radiosurgery-induced nausea and vomiting by ondansetron: evidence of a direct effect on the central nervous system chemoreceptor trigger zone. Surg Neurol 42:249–252PubMedCrossRef

24.

Khoo VS, Rainford K, Horwich A, Dearnaley DP (1997) The effect of antiemetics and reduced radiation fields on acute gastrointestinal morbidity of adjuvant radiotherapy in stage I seminoma of the testis: a randomized pilot study. Clin Oncol (R Coll Radiol) 9:252–257CrossRef

25.

Lanciano R, Sherman DM, Michalski J, Preston AJ, Yocom K, Friedman C (2001) The efficacy and safety of once-daily Kytril (granisetron hydrochloride) tablets in the prophylaxis of nausea and emesis following fractionated upper abdominal radiotherapy. Cancer Invest 19(8):763–772PubMedCrossRef

26.

Logue JP, Magee B, Hunter RD, Murdoch RD (1991) The antiemetic effect of granisetron in lower hemibody radiotherapy. Clin Oncol (R Coll Radiol) 3:247–249CrossRef

27.

Maisano R, Pergolizzi S, Settineri N (1998) Escalating dose of oral ondansetron in the prevention of radiation induced emesis. Anticancer Res 18:2011–2014PubMed

28.

Mystakidou K, Kouloulias V, Nikolaou V et al (2010) A comparative study of prophylactic antiemetic treatment in cancer patients receiving radiotherapy. J BUON 15:29–35PubMed

29.

Wong RKS, Paul N, King K et al (2006) 5-Hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: a placebo-controlled randomised trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). J Clin Oncol 24(21):3458–3464PubMedCrossRef

30.

Morita M, Kuwano H, Ohno S, Kitamura K, Sugimachi K (2000) Antiemetic effect of ramosetron during hyperthermo-chemo-radiotherapy for esophageal cancer. Anticancer Res 20:3631–3636PubMed

31.

Okamoto S, Takahashi S, Tanosaki R et al (1996) Granisetron in the prevention of vomiting induced by conditioning for stem cell transplantation: a prospective randomized study. Bone Marrow Transplant 17:679–683PubMed

32.

Prentice HG, Cunningham S, Ganhi L, Cunningham J, Collis C, Hamon MD (1995) Granisetron in the prevention of irradiation-induced emesis. Bone Marrow Transplant 15:445–448PubMed

33.

Aass N, Hatun D, Thoresen M, Fossa SD (1997) Prophylactic use of tropisetron or metoclopramide during adjuvant abdominal radiotherapy of seminoma stage I: a randomised, open trial in 23 patients. Radiother Oncol 45(2):125–128PubMedCrossRef

34.

Abbott B, Ippoliti C, Bruton J, Neumann J, Whaley R, Champlin R (1999) Antiemetic efficacy of Granisetron plus dexamethasone in bone marrow transplant patients receiving chemotherapy and total body irradiation. Bone Marrow Transplant 23:265–269PubMedCrossRef

35.

Gibbs SJ, Cassoni AM (1996) A pilot study to evaluate the cost-effectiveness of Ondansetron and Granisetron in fractionated total body irradiation. Clin Oncol 8:182–184CrossRef

36.

Sorbe B, Berglind AM (1992) Tropisetron, a new 5-HT3-receptor antagonist, in the prevention of radiation-induced nausea, vomiting and diarrhoea. Drugs 43(Suppl 3):33–39PubMedCrossRef

37.

Aapro M, Blower P (2005) 5-Hydroxytryptamine type-3 receptor antagonists for chemotherapy-induced and radiotherapy-induced nausea and emesis: can we safely reduce the dose of administered agents? Cancer 104(1):1–18PubMedCrossRef

38.

Salvo N, Doble B, Khan L, et al. (2012) Prophylaxis of radiation-induced nausea and vomiting using 5-hydroxytryptamine-3 serotonin receptor antagonists: a systematic review of randomized trials. Int J Radiat Oncol Biol Phys 82:408

39.

Blower PR (2003) Granisetron: relating pharmacology to clinical efficacy. Support Care Cancer 11:93–100PubMed

Title: Timing and duration of 5-HT3 receptor antagonist therapy for the prophylaxis of radiotherapy-induced nausea and vomiting: a systematic review of randomized and non-randomized studies
Authors: Kristopher Dennis
Leila Makhani
Ernesto Maranzano
Petra Feyer
Liang Zeng
Carlo De Angelis
Lori Holden
C. Shun Wong
Edward Chow
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: Journal of Radiation Oncology / Issue 3/2013
Print ISSN: 1948-7894
Electronic ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-012-0030-2

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