Ibrahim E M, Al-Idrissi H Y, Ibrahim A, Absood G, Al-Dossary E, Al-Jammaa A, Al-Ethan S, Eliopoulos A
Eur J Cancer Clin Oncol. 1986 Mar;22(3):283-8. doi: 10.1016/0277-5379(86)90392-5.
A double-blind, randomized, crossover study was conducted to compare the efficacy and safety of high-dose dexamethasone and high-dose metoclopramide in the treatment of chemotherapy-induced nausea and vomiting. All entered patients had no prior chemotherapy and all received inpatient emetogenic chemotherapy mainly without cisplatin. Of the 40 evaluable patients, 23 (58%) had no vomiting with dexamethasone compared with only 11 (28%) receiving metoclopramide (P less than 0.025). Dexamethasone was found to have less adverse effect than metoclopramide on patient's appetite and activity (P less than 0.025 and P less than 0.01, respectively). Twenty-one patients (53%) developed mild to severe somnolence with metoclopramide compared to only seven (18%) who experienced this adverse effect with dexamethasone (P less than 0.01). Six patients (15%) developed extrapyramidal manifestations with metoclopramide, but none with dexamethasone. Furthermore, during dexamethasone therapy, patients developed less diaphoresis, insomnia, headache and dizziness. Upon questioning patients about their preference to future use of the antiemetic drug therapy, 28 patients (70%) preferred dexamethasone, two (5%) preferred metoclopramide and 10 (25%) found no difference. We conclude that high-dose dexamethasone has a greater antiemetic activity and is more safe than high-dose metoclopramide in patients receiving emetogenic chemotherapy mainly without cisplatin.
进行了一项双盲、随机、交叉研究，以比较高剂量地塞米松和高剂量甲氧氯普胺治疗化疗引起的恶心和呕吐的疗效及安全性。所有入选患者均未接受过化疗，且均接受了主要不含顺铂的致吐性化疗住院治疗。在40例可评估患者中，23例（58%）使用地塞米松后未出现呕吐，而接受甲氧氯普胺治疗的患者中只有11例（28%）未呕吐（P<0.025）。结果发现，地塞米松对患者食欲和活动的不良影响比甲氧氯普胺小（分别为P<0.025和P<0.01）。21例（53%）使用甲氧氯普胺的患者出现了轻度至重度嗜睡，而使用地塞米松出现这种不良反应的患者只有7例（18%）（P<0.01）。6例（15%）使用甲氧氯普胺的患者出现锥体外系表现，而使用地塞米松的患者均未出现。此外，在地塞米松治疗期间，患者出汗、失眠、头痛和头晕的情况较少。在询问患者对未来使用止吐药物治疗的偏好时，28例（70%）患者更喜欢地塞米松，2例（5%）更喜欢甲氧氯普胺，10例（25%）认为没有差别。我们得出结论，在主要接受不含顺铂的致吐性化疗的患者中，高剂量地塞米松比高剂量甲氧氯普胺具有更强的止吐活性且更安全。
