Abstract
[Purpose] Multiagent chemotherapy including a moderately emetogenic anticancer drug for brain tumors decreases the quality of life of children owing to frequent episodes of sudden nausea and vomiting. The standard antiemetic regimen is a steroid combined with a 5-HT3 receptor antagonist. Recently, aprepitant, an NK-1 receptor antagonist, has been approved in Japan, and combination therapy with 3 drugs including aprepitant is recommended according to many guidelines. However, the safety and efficacy of aprepitant use in pediatric patients have not been established. Accordingly, we examined whether the concomitant use of aprepitant affects the efficacy and safety of the standard antiemetic regimen for chemotherapy in pediatric patients with brain tumors. [Methods] We retrospectively compared the outcomes of 10 pediatric patients with brain tumors concomitantly treated with aprepitant and 21 patients treated with a standard regimen, by reviewing the medical records of these patients. The 31 patients ranged in age from 7 to 18 years. The chemotherapy regimens were cyclophosphamide-carboplatin-etoposide and cisplatin-etoposide. [Results] No major adverse events were encountered. The frequencies of vomiting, nausea and particularly acute phase emesis were lower among patients receiving aprepitant (27.2%, 16.7%, and 41.9%, respectively) than among patients receiving the standard regimen. [Conclusion] Aprepitant use in pediatric patients, at the same dose as that used in adults, may be superior to the standard antiemetic regimen for moderately emetogenic anticancer therapy. Further studies are warranted to determine the optimal dosage.
