Duration of dexamethasone administration for the prevention of chemotherapy-induced nausea and vomiting – A systematic review and meta-analysis

[Display omitted] •Systematic review comparing short (1–2 day) and long (3+ days) course dexamethasone.•No difference found between short or long course dexamethasone in preventing CINV.•Short course dexamethasone was associated with fewer adverse effects.•Subgroup analysis by emetogenicity or use of NK1 inhibitor showed no difference. Chemotherapy-induced nausea and vomiting (CINV) is the most common non-haematological toxicity of chemotherapy. A systematic review and meta-analysis comparing short course (1–2 days) with long course (3+ days) dexamethasone in preventing CINV was performed in accordance with the PRISMA statement. 1535 articles were screened to identify the 11 studies included in the review. Nine studies of 1892 patients were included in meta-analysis. There was no significant difference in complete response of nausea and vomiting between a short or long course of dexamethasone (RR 0.98, 95 % CI 0.89–1.07, p = 0.58). There was a lower risk of adverse events with a short course of dexamethasone (RR 0.80, 95 % CI 0.64−0.99, p = 0.04). There was no significant difference between a short or long course of dexamethasone in preventing nausea or vomiting, but a short course was associated with fewer adverse effects. PROSPERO protocol: CRD42019133785