Anthropometric and pharmacotherapeutic variables on acute emesis induced by cisplatin-containing chemotherapy

Ann Pharmacother. 2000 May;34(5):573-9. doi: 10.1345/aph.19188.

Abstract

Objective: To characterize the effects of anthropometric and pharmacotherapeutic variables on acute emesis induced by cisplatin-containing regimens with dosages > or =50 mg x m(-2).

Methods: A prospective, cross-sectional, noncontrolled study was performed to analyze acute vomiting during the first 24 hours in patients treated in a Spanish hospital. The patients received an intravenous combination of drugs (2 doses of metoclopramide 3 mg/kg, dexamethasone 20 mg) as first-choice antiemetic therapy. Intravenous ondansetron 8 mg and dexamethasone 20 mg served as an alternative regimen in patients <30 years old with a history of extrapyramidal manifestations or emesis in previous cycles. Therapeutic failure was used as a dependent variable, defined as three or more vomiting episodes documented by the patients. Other variables were the chemotherapeutic regimen; antiemetic regimen; patient gender, age, weight, and height; and cycle number. The reference logistic model and two reduced-models derived from the latter were designed. The logistic models were subsequently validated by means of receiving operating characteristic curves.

Results: A total of 319 cycles involving 106 patients were studied. The metoclopramide regimen was administered in 66% of the cycles. The therapeutic failure rate was 21% for the metoclopramide regimen and 32% for the ondansetron treatment. The logistic model developed identified the type of chemotherapeutic regimen provided as the most significant prognostic variable (p < 0.0001). Patient weight (odds ratio 1.64) and height (odds ratio 1.28) were identified as prognostic factors related with therapeutic failure.

Conclusions: The type of chemotherapeutic regimen administered and the anthropometric characteristics of the patients exert a clear conditioning effect on risks associated with therapeutic failure against acute emesis following high-dose cisplatin therapy. Such anthropometric parameters have not been previously identified as prognostic factors.

MeSH terms

  • Acute Disease
  • Age Factors
  • Antiemetics / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Body Weights and Measures*
  • Chlorpromazine / therapeutic use*
  • Cisplatin / adverse effects*
  • Cross-Sectional Studies
  • Dexamethasone / therapeutic use*
  • Drug Combinations
  • Humans
  • Logistic Models
  • Metoclopramide / therapeutic use*
  • Middle Aged
  • Multivariate Analysis
  • Ondansetron / therapeutic use
  • Orphenadrine / therapeutic use*
  • Prognosis
  • Prospective Studies
  • Sex Factors
  • Vomiting / chemically induced*
  • Vomiting / prevention & control

Substances

  • Antiemetics
  • Antineoplastic Agents
  • Drug Combinations
  • chlorpromazine, dexamethasone, metoclopramide, orphenadrine drug combination
  • Ondansetron
  • Dexamethasone
  • Orphenadrine
  • Metoclopramide
  • Cisplatin
  • Chlorpromazine