Aksoylar S, Akman S A, Ozgenç F, Kansoy S
Department of Pediatric Oncology, Ege University Medical School, Izmir, Turkey.
Pediatr Hematol Oncol. 2001 Sep;18(6):397-406. doi: 10.1080/088800101316922029.
Tropisetron and granisetron are selective serotonin (5-HT3) antagonists that have been proven effective in the prevention of nausea and vomiting in adults and children receiving cancer chemotherapy. This prospective, randomised study was designed to compare the efficacy of the two agents in the prevention of vomiting and nausea in children receiving highly emetogenic chemotherapy for various malignancies. A total of 51 children (mean age: 7.7 +/- 4.8 year) were studied in 133 chemotherapy cycles. In 66 chemotherapy cycles, the children received tropisetron as an antiemetic agent in a dose of 0.2 mg/kg/24 h intravenously and, in 67 cycles, they received granisetron 40 micrograms/kg/24 h intravenously before cytotoxic drug administration during the days they received chemotherapy. The response per 24 h of chemotherapy was defined as complete (no nausea and vomiting), partial (1-4 events of vomiting and/or nausea), and failure (more than 4 events of vomiting and/or nausea). Efficacy of antiemetic therapy was evaluated as acute (Day 1) and overall was based on the worst day during the chemotherapy. Complete control of acute vomiting was achieved in 74% of tropisetron and 88% of granisetron patients (P = 0.04), and complete control of acute nausea in 56% and 82% respectively (p = 0.002). Overall response by means of complete control of both vomiting and nausea during the whole therapy period was 29% of tropisetron group and 55% of granisetron group (p = 0.007). The statistical analysis (depending on the emetogenicity of the chemotherapy cycles) showed increased efficacy of granisetron in highly (grade 3) emetogenic chemotherapy cycles (p = 0.002), whereas there was no difference in the very highly emetogenic cycles (p = 0.7). Also, granisetron was found to be more effective than tropisetron, especially in patients heavier than 25 kg (p = 0.02). The adverse reactions were few and mild. There were no differences in the tolerability of the two antiemetic therapy modalities. In conclusion, granisetron was found to be more effective than tropisetron in controlling nausea and vomiting in children receiving highly emetogenic chemotherapy. This increased antiemetic efficacy of ganisetron might have been related to maximal dose differences according to body weight.
托烷司琼和格拉司琼是选择性5-羟色胺（5-HT3）拮抗剂，已被证明在预防接受癌症化疗的成人和儿童恶心和呕吐方面有效。这项前瞻性随机研究旨在比较这两种药物在预防接受高致吐性化疗的各种恶性肿瘤儿童呕吐和恶心方面的疗效。共对51名儿童（平均年龄：7.7±4.8岁）进行了133个化疗周期的研究。在66个化疗周期中，儿童静脉注射剂量为0.2mg/kg/24h的托烷司琼作为止吐药，在67个周期中，他们在接受化疗的日子里，在细胞毒性药物给药前静脉注射40μg/kg/24h的格拉司琼。每个化疗24小时的反应定义为完全缓解（无恶心和呕吐）、部分缓解（1-4次呕吐和/或恶心事件）和未缓解（超过4次呕吐和/或恶心事件）。止吐治疗的疗效评估为急性（第1天），总体疗效基于化疗期间最严重的一天。托烷司琼组74%的患者和格拉司琼组88%的患者实现了急性呕吐的完全控制（P = 0.04），急性恶心的完全控制率分别为56%和82%（P = 0.002）。在整个治疗期间，通过完全控制呕吐和恶心来衡量的总体缓解率，托烷司琼组为29%，格拉司琼组为55%（P = 0.007）。统计分析（取决于化疗周期的致吐性）显示，在高（3级）致吐性化疗周期中，格拉司琼的疗效更高（P = 0.002），而在极高致吐性周期中没有差异（P = 0.7）。此外，发现格拉司琼比托烷司琼更有效，尤其是在体重超过25kg的患者中（P = 0.0
