Role of maintenance oral dexamethasone in prophylaxis of delayed emesis caused by moderately emetogenic chemotherapy

Summary Background: Although usually a problem of cisplatin-bas ed chemotherapy, delayed emesis can cause severe distress in patients treated with cyclophosphamide. Dexamethasone has been shown to be effective in the control of cisplatin-induced delayed emesis, but its role against the delayed problem in patients treated with cyclophosphamide has not been demonstrated. Our study was conducted to evaluate the effect of dexamethasone in delayed emesis induced by cyclophosphamide. Patients and methods: Ninety-eight patients were given i.v. granisetron and i.v. dexamethasone before chemotherapy, and randomised to receive either oral dexamethasone 4 mg twice daily as maintenance or no maintenance. Results: Ninety-four patients were evaluable. Of those given maintenance oral dexamethasone, 57% had complete and 30% had major control of delayed emesis, versus 33% and 15%, respectively, of patients who did not receive maintenance. Side effects are mainly constipation and headache. Conclusion: The result shows that oral dexamethasone is an effective agent against cyclophosphamide-induced delayed emesis.