[Antiemetic treatment with metoclopramide and high-dose lorazepam and additional long-term treatment with lorazepam during CDDP administration].

We studied the antiemetic effects of a combination therapy consisting of metoclopramide (MCP) and high-dose lorazepam (HiLor; 3-4.5 mg/day) in patients with lung cancer who were being treated with cis-diamminedichloroplatinum (CDDP). This study was designed in order to compare the antiemetic efficacy of two different-term treatments. In the short-term treatment, MCP and HiLor were given for three days after the beginning of the CDDP regimen (group 1). In the long-term treatment (group 2), the same dose of MCP and a decreased dose of HiLor (1.5-3 mg/day) were administered for another three days (eventually for 6 days). Thirty-one trials were evaluated in eighteen patients for 8 days after the CDDP treatments initiated. The frequency of episodes of vomiting was less than two times in 70% and 82% of trails, in group 1 and group 2, respectively. This finding indicates that the combination therapy of MCP and HiLor for a long period would be the same or more effective than that of MCP and steroid agents. Furthermore, in group 2, the frequency and severity of late emesis were significantly less than in group 1, and appetite recovery was observed significantly earlier than in group 1. There was no side effect related to the administration of MCP and HiLor during this study. These findings suggested that the combination treatment of MCP and HiLor with a decreased dose of HiLor for a long period was markedly effective for antiemesis in patients treated with CDDP, especially for the prophylaxis of CDDP-induced late emesis.