The emetic risk classification of cisplatin is different according to guidelines and its doses. In Japan, cisplatin split regimen, which is classified as highly emetogenic risk, has been recommended the use of aprepitant, together with 5-HT3 receptor antagonist and dexamethasone. However, cisplatin split regimen has not been investigated enough for validation of the use as an aprepitant.Purpose
To evaluate the efficacy of 3 days aprepitant administration in cisplatin split regimen (20 mg/m2/day; days 1–4, 22–25, 43–46) in combination with radiation.Subjects and methods
In this study, we used patients' records retrospectively. We compared the worst grade of nausea in 23 patients who had used aprepitant (group A: January 2010 to June 2010) and 34 patients who did not use aprepitant (group B: July 2011 to December 2012).Results
In group A, median age: 60 years [range 35–73], male/female: 18/5, and ECOG PS 0/1: 20/3. In group B, median age: 62 years [range 31–71], male/female: 30/4, and ECOG PS 0/1: 31/3. Worst nausea grade was 0/1/2: 21/2/0 in group A and 0/1/2: 19/9/6 in group B. The percentage of nausea was significantly lower in group A compared with group B (8% versus 44%, P < 0.01). Of six patients who had grade 2 nausea, five patients used aprepitant in next course of chemotherapy, and 60% of them improved their nausea.Conclusion
Aprepitant could be effective in cisplatin split regimen as prophylactic antiemetics.