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- Title
Efficacy of one-day versus multiple-day dexamethasone for chemotherapy-induced nausea and vomiting in lung cancer patients receiving carboplatin-based chemotherapy: a propensity score–matched analysis.
- Authors
Hayashi, Toshinobu; Shimokawa, Mototsugu; Mizuki, Fumitaka; Matsuo, Koichi; Kawada, Kei; Nakano, Takafumi; Egawa, Takashi
- Abstract
Purpose: Dexamethasone (DEX)-sparing strategies (one-day DEX) with palonosetron as doublet antiemetic prophylaxis have previously been studied. However, DEX-sparing regimens with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and aprepitant (APR), as triplet antiemetic prophylaxis, have not been evaluated. This study aimed to evaluate the efficacy of a combination of 5-HT3RA, APR, and DEX on day 1 of carboplatin (CBDCA)-based chemotherapy in patients with lung cancer. Methods: Data were pooled from a nationwide, multicenter, prospective observational study using propensity score–matched analysis to compare the incidence of chemotherapy-induced nausea and vomiting (CINV) between one- and multiple-day DEX regimens in combination with 5-HT3RA plus APR. Results: Incidence of delayed nausea was significantly higher in the one-day than in the multiple-day DEX group. Incidence of nausea was also significantly higher in the one-day than in the multiple-day DEX group on days 3–5. Kaplan–Meier curves for nausea showed a significant difference between the two groups; however, there was no significant difference in the occurrence of vomiting or the Kaplan–Meier curves of time to vomiting. Conclusion: To the best of our knowledge, this study is the first to evaluate the efficacy of a DEX-sparing regimen by comparing one- and multiple-day DEX combined with 5-HT3RA and APR concerning CINV incidence in lung cancer patients receiving CBDCA-based chemotherapy. Antiemetic regimens of one-day DEX result in poor control of delayed nausea; therefore, we recommend the application of the DEX-sparing strategy only after careful patient selection while considering the development of nausea.
- Subjects
LUNG cancer; NAUSEA; CANCER patients; VOMITING; DEXAMETHASONE
- Publication
Supportive Care in Cancer, 2021, Vol 29, Issue 9, p5029
- ISSN
0941-4355
- Publication type
Article
- DOI
10.1007/s00520-021-06061-8