Comparison of Lorazepam,Diphenhydramine,Haloperidol Combined with Tropisetron and Dexamethasone Combined with Tropisetron Efficacy in Preventing Emesis Induced by Highly Emetogenic Chemotherapy

Objective To compare the efficacy of lorazepam, diphenhydramine and haloperidol（abbreviation as ABH）combined with Tropisetron therapies in preventing emesis induced by highly emetogenic chemotherapy refer to 2011 edition of MASCC antiemetic guidelines. Methods One hundred and four patients treated with highly emetogenic single day chemotherapy were randomized into ABH and dexamethasone group. Both groups were given tropisetron 5mg intravenous infusion 30 minutes before chemical therapy. Patients in group ABH took lorazepam 0.34 mg, diphenhydramine 25 mg, haloperidol 1.5mg orally thrice a day on the therapy day and three days later. Group dexamethasone was given dexamethasone 20 mg once on the therapy day and 8 mg twice three days later. To study the control rate of acute,delayed nausea and vomiting and the patient's living quality,we used the MASCC antiemetic questionnaires and the functional living index-Emesis questionnaire. Results Fifty two patients were enrolled into each group. Both groups had a good control of acute，delayed nausea and vomiting.The control rates of acute nausea in Group ABH and Group dexamethasone were 62% vs.52%,77% vs. 65% in delayed nausea，and 88% vs. 87% in acute vomiting，77%vs. 65% in delayed vomiting.Group ABH was better than group dexamethasone, but there was no statistical difference between them,which may be caused by the small sample sizes. It's worth mentioning that Group ABH was superior to Group dexamethasone in the control of delayed nausea degree（2.63 vs. 3.69）（P<0.05）. The patient's living quality was moderately influenced but there was no statistical difference and serious side effects in both groups. Conclusion Lorazepam, diphenhydramine and haloperidol （ABH）combined with 5HT-3 receptor antagonist therapy has a good effect in preventing emesis induced by highly emetogenic chemotherapy, with little side effects, and can be to trent chemotherapy induced nausea and vomiting (CINV).