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

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Abstract
Although usually a problem of cisplatin-based 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 dem onstrated. Our study was conducted to evaluate the effect of dexamethasone in delayed emesis induced by cyclophospha mide. Ninety-eight patients were given i.v. granisetron and i.v. dexamethasone before chemotherapy, and randomised to receive either oral dexaniethasone 4 mg twice daily as maintenance or no maintenance. Ninety-four patients were evaluable. Of those given maintenance oral dexarnethasone, 57% had complete and 30% had major control of delayed emesis, versus 33% and 15%, respectively, of patients who did not receive main tenance. Side effects are mainly constipation and headache. The result shows that oral dexamethasone is an effective agent against cyclophosphainide-induced de layed emesis.