Granisetron plus methylprednisolone versus granisetron alone in prevention of emesis associated with cisplatin-containing chemotherapies

Aim - To compare granisetron alone (GRN) with a combination of granisetron and methylprednisolone (COM) in the prevention of acute and delayed emesis due to high dose cisplatin (>80 mg/m(2)). Methods - Between November 1992 and December 1993, 60 patients about to receive cisplatin-containing chemotherapy were enrolled in the study and randomly assigned to GRN or COM treatment. All patients received 3 mg of granisetron on day 1, Those in the COM group received in addition 250 mg of intravenous methylprednisolone twice a day on day 1, followed by 125 mg once a day from day 2 to 5, Results - On day 1, complete protection against vomiting was achieved in 27 patients (90.0%) in the COM group and in 18 patients (60.0%) in the GRN group (p<0,05); on day 2 through to 7, it was achieved in 66.7% of the COM group compared with 20.0% of the GRN group (p<0.01). On day 1, 24 patients (80.0%) in the COM group experienced no nausea compared with 13 patients (43.3%) in the GRN group (p<0,05), On day 2 through to 7, the respective percentages were 40.0% and 6.7% (p<0,5), Conclusion - Compared to granisetron alone, a combination of granisetron and methylprednisolone provides a higher rate of complete protection against emesis - especially delayed emesis - induced by cisplatin-containing chemotherapy.