The antiemetic efficacy of tropisetron plus dexamethasone as compared with conventional metoclopramide‐dexamethasone combination in Orientals receiving cisplatin chemotherapy: a randomized crossover trial

1We report a single‐blind randomized crossover trial comparing the efficacy of tropisetron plus dexamethasone (TROPDEX) vs conventional combination of metoclopramide, dexamethasone and diphenhydramine (METDEX) in prevention of acute and delayed vomiting in Chinese patients receiving high dose cisplatin. 2Thirty‐six consecutive patients with nasopharyngeal carcinoma were entered into the study, all received cisplatin at a dose range of 60–100 mg/m2. Patients were randomized in the sequence of antiemetic regimens used in two consecutive cycles. 3The TROPDEX regimen consisting of tropisetron 5 mg i.v. and dexamethasone 20 mg i.v. given on day 1 of chemotherapy, followed by oral maintenance with tropisetron 5 mg daily and dexamethasone 4 mg twice daily from day 2 to 6. The METDEX regimen consisting of metoclopramide 1 mg kg−1 i.v., dexamethasone 20 mg i.v. and diphenhydramine 25 mg i.v. given before chemotherapy and then 2 hourly for two more doses on day 1, followed by oral metoclopramide 20 mg 6 hourly from day 2 to 6. 4Complete control of acute vomiting was observed in 64% of patients with TROPDEX as compared with 14% with METDEX (P