Manifest Anxiety Scale for evaluation of effects of granisetron in chemotherapy with CDDP and 5FU for head and neck cancer

The level of anxiety was examined before treatment by means of the Manifest Anxiety Scale (MAS) in 41 patients with squamous cell carcinoma of the head and neck. They received 5 days of neoadjuvant chemotherapy with cisplatin (CDDP) and 5-fluorouracil (5FU). Granisetron (KYT) was administered daily from day 1 to day 5. Nausea, vomiting, appetite, and well-being were assessed during and after chemotherapy. The relation between the effects of KYT and anxiety was studied. Seventeen patients were proven to have anxiety and were compared with the other 24 patients. In patients with anxiety, the percentage well-being was significantly lower on days 1 and 2 (P=0.008, 0.001). The rate of freedom from nausea was significantly lower from day 4 to day 9 for anxiety patients (P=0.010-0.050). The percentage of anxiety patients without loss of appetite was significantly lower from day 6 to 9 (p=0.001-0.020). The rate of freedom from vomiting was significantly lower on days 4, 5 and 7 for anxiety patients (P=0.024, 0.024, 0.014). The results indicate that the effect of KYT was significantly lower from day 3 to day 7 for anxiety patients (P=0.008-0.045). The anxiety group had significantly poorer well-being at the beginning of chemotherapy, and were not responsive to KYT in the delayed phase. Our results prove that anxiety patients show delayed emesis, and the administration of KYT is considered insufficient. It may be important to co-administer a tranquilizer to any patient who exhibit anxiety as defined by the MAS, in order to reduce delayed emesis.