Prevention of cisplatin-based chemotherapy-induced delayed nausea and vomiting using triple antiemetic regimens: a mixed treatment comparison
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Qi Shi1,*, Wen Li1,*, Hongjia Li1, Qiqi Le3, Shanshan Liu1, Shaoqi Zong1, Leizhen Zheng2, Fenggang Hou1
1Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
2Oncology Department of Xin Hua Hospital Affiliated To Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China
3Digestive Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
*These authors contributed equally to this work
Fenggang Hou, e-mail: firstname.lastname@example.org
Leizhen Zheng, e-mail: email@example.com
Keywords: chemotherapy-induced nausea and vomiting (CINV), highly emetogenic chemotherapy, cisplatin-based chemotherapy
Received: November 28, 2015 Accepted: February 24, 2016 Published: March 22, 2016
A variety of triple antiemetic regimens are being used to prevent cisplatin-based chemotherapy induced delayed emesis and nausea in cancer patients. We performed a network meta-analysis to compare the efficacies of the different regimens. Electronic searches of the PubMed, Cochrane Library and MEDLINE databases were performed to identify randomized controlled trials, and data were analyzed using JAGS, Stata 14.0 and R project. The primary outcome was a complete response (CR). The secondary outcomes were no vomiting (NV) and no nausea (NN). Among the 398 studies identified, 10 were eligible and included, providing data on nine regimens. In the CR analysis, the absolute rank of netupitant + palonosetron + dexamethasone (NEPA) was 0.8579. In the NV and NN analyses, NEPA’s absolute ranks were 0.8631 and 0.7902, respectively. The compliance of patients treated with rolapitant + granisetron + dexamethasone (RGD) was the best due to a low incidence of adverse events, and good compliance was also observed with NEPA. It was difficult to achieve good compliance with aprepitant + granisetron + dexamethasone (AGD). Overall, NEPA was the best regimen, and aprepitant + ondansetron + dexamethasone (AOD) is also worthy of recommendation because of its low cost and good effect. For patients with severe constipation, hiccups, asthenia and/or delayed nausea, RGD is worthy of consideration.
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