Journal of Clinical Oncology, Vol 3, 1127-1132, Copyright © 1985 by American Society of Clinical Oncology
A comparison of the antiemetic efficacy of prochlorperazine and metoclopramide for the treatment of cisplatin-induced emesis: a prospective, randomized, double-blind study
BI Carr, M Bertrand, S Browning, JH Doroshow, C Presant, B Pulone and LR Hill
This study compared high-dose metoclopramide and prochlorperazine for their
antiemetic activities in the treatment of patients with solid tumors
receiving cisplatin-based cancer chemotherapy, in a prospective,
double-blind fashion. Sixty patients were entered in the study, and 28
patients on each regimen were evaluable. For regimen 1, metoclopramide was
given intravenously (IV) over 15 minutes at a dose of 2 mg/kg 30 minutes
before, 30 minutes after, and three hours after treatment with cisplatin.
In regimen 2, prochlorperazine was given IV 30 minutes before and three
hours after the cisplatin; a placebo was administered at 30 minutes after
cisplatin. There was no statistically significant difference between the
two regimens in their antiemetic efficacies during the first three hours.
For emesis that occurred from three to 24 hours after administration of
cisplatin, prochlorperazine was marginally superior. The median number of
emeses in the metoclopramide regimen was 2.5 (range, 0 to 10+) compared to
1.0 (range, 0 to 10+) in the prochlorperazine regimen. This is not a
significant difference. The overall incidence of adverse reactions was
greater in the metoclopramide regimen, with drowsiness being the most
common toxicity for both antiemetic programs. Thus, IV high-dose
metoclopramide and prochlorperazine are similar and effective in the
management of cisplatin-induced emesis. IV prochlorperazine at 20-mg dosage
is surprisingly effective.
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