Comparison of Tropisetron Versus Tropisetron Plus Methylprednisolone in Prevention of Chemotherapy Induced Emesis

[Purpose]To evaluate the efficacy and toxicity of tropisetron and its combination with methylprednisolone in prevention of cisplatin based chemotherapy induced emesis, and compared with tropisetron alone. [Methods] Thirty-six patients who received two consecutive courses of cisplatin based chemotherapy were randomized into group A(tropisetron 5mg intravenously day1 - 3 plus methylprednisolone 120mg intravenously day1 - 3), or group B(tropisetron 5mg intravenously day1 - 3) . [Results] Completed response(CR)was obtained on day 1 in 94.4%of patients who received the combination schedule versus 77.8% of those who received tropisetron alone(P 0.05) , and in 69.4% - 80.6% versus 22.2% -44.7% on day 2 to 4(P 0.05).The overall response rates(day 1 to 4)were 88.9% -97.2% versus 72.2% - 86.1%(P 0.05) . Additionally,significantly less nausea was observed in the combination group on day 2 to 4. Adverse effects were mild and well tolerated without significant differences between two groups. [Conclusion] Methylprednisolone can enhance the efficacy of tropisetron in cisplatin based chemotherapy induced emesis. It is suitable as first-line therapy (combined with a methylprednisolone) for the prevention of acute nausea and vomiting in patients treated with moderately to severely emetogenic chemotherapeutic agents.