Duration of dexamethasone administration for the prevention of chemotherapy-induced nausea and vomiting - A systematic review and meta-analysis

Crit Rev Oncol Hematol. 2020 Aug:152:103012. doi: 10.1016/j.critrevonc.2020.103012. Epub 2020 Jun 2.

Abstract

Background: Chemotherapy-induced nausea and vomiting (CINV) is the most common non-haematological toxicity of chemotherapy.

Methods: A systematic review and meta-analysis comparing short course (1-2 days) with long course (3+ days) dexamethasone in preventing CINV was performed in accordance with the PRISMA statement.

Results: 1535 articles were screened to identify the 11 studies included in the review. Nine studies of 1892 patients were included in meta-analysis. There was no significant difference in complete response of nausea and vomiting between a short or long course of dexamethasone (RR 0.98, 95 % CI 0.89-1.07, p = 0.58). There was a lower risk of adverse events with a short course of dexamethasone (RR 0.80, 95 % CI 0.64-0.99, p = 0.04).

Conclusion: There was no significant difference between a short or long course of dexamethasone in preventing nausea or vomiting, but a short course was associated with fewer adverse effects. PROSPERO protocol: CRD42019133785.

Keywords: Chemotherapy-induced nausea and vomiting; Corticosteroids; Dexamethasone; Meta-analysis; NK1 inhibitors; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antiemetics* / therapeutic use
  • Antineoplastic Agents* / adverse effects
  • Dexamethasone* / therapeutic use
  • Humans
  • Nausea* / chemically induced
  • Nausea* / prevention & control
  • Vomiting* / chemically induced
  • Vomiting* / prevention & control

Substances

  • Antiemetics
  • Antineoplastic Agents
  • Dexamethasone