Authors (including presenting author) :
YUEN CM(1), LEUNG NTK (1), KOO SYC (1), LAM KM (1), CHAN SYA(2), KONG HS(1), CHUI CMW(1) , LUK MY (2)
Affiliation :
(1) Department of Pharmacy, QMH
(2) Clinical Oncology Department, QMH
Introduction :
The incidence of nausea and vomiting post-radiotherapy is often underestimated, where up to 50%-80% may experience nausea and vomiting during radiotherapy. High dose Cisplatin, which is known to have high emetogenicity and associated with delayed emesis, is used for chemoradiation in treating head and neck cancer. Yet, no recommendations are available to suggest the optimal antiemetics prophylaxis for these patients. Transdermal (TD) Granisetron has been introduced and used in this group of patients in Clinical Oncology Department at Queen Mary Hospital since November 2017, in combination with oral Aprepitant and intravenous Dexamethasone. This study was designed to compare the effect of TD Granisetron and intravenous (IV) Ondansetron in preventing nausea and vomiting associated with Cisplatin chemoradiation.
Objectives :
To compare the efficacy of TD Granisetron versus intravenous Ondansetron in head and neck cancer patients who received Cisplatin chemoradiation
Methodology :
Head and neck cancer patients on Cisplatin chemoradiation who were prescribed with TD Granisetron from January to June 2018 and same number of matched historical control on IV Ondansetron were recruited. Outcome measures included percentages of patients with (1) nausea and vomiting (2) grade 2 or above nausea (3) 3 times or more vomiting per day. Descriptive statistics for both groups were presented as percentages and compared using the Fisher’s Exact Test. 95% confidence interval is adopted and p<0.05 is taken as the level of significance.
Result & Outcome :
A total of 16 eligible patients prescribed with TD Granisetron and the same number of matched historical control was included. Preliminiary results showed that 88% versus 50% of patients reported nausea after chemoradiation in Granisetron and Ondansetron group respectively. Fifty-six percent of patients in Granisetron group reported grade 2 or above nausea while none was reported in Ondansetron group. Sixty-three percent of patients in Granisetron group reported vomiting and 25% had reported 3 times of vomiting per day, compared to 17% of Ondansetron group patients reported vomiting
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