Nausea and vomiting are among the most frequent and severe acute side effects of cytotoxic therapy and are not optimally controlled by conventional antiemetics which are unsatisfactory due to their poor efficacy and their adverse effects. This situation warrants the evaluation of new classes of antiemetic agents such as the 5HT3 receptor antagonists. Fitfty children (23 female, 27 male) with a medyan age of 10 years (range 6 months-18 years) were administered the 5HT3 receptor antagonist tropisetron, in 239 chemotherapy courses. Tropisetron was given intravenously (i.v.) at 0.2 mg/kg/day (maximum 5 mg) during the chemotherapy. The number of emetic episodes and nausea was recorded. During the first 24-hour period of the courses, a good control of emesis was achieved in 67% (<3 emetic episodes) and a good control of nausea in 86% (none or mild) of the 49 cisplatin containing chemotherapy courses. For 190 courses of those not including cisplatin, same values were found as 72% and 84% respectively. For all courses, a good control of emesis and nausea was recorded in 70% and 84% respectively during the first 24 hours of chemotherapy. The same values were 63% and 76% respectively for the "worst day" (the day when most emetic episodes and nausea were encountered) of treatment. Mild side effects were recorded in 9% of the courses which didn't require to abondan chemotherapy. In conclusion, tropisetron (Navoban Novartis) is an effective and safe antiemetic during treatment of pediatric solid tumors.

Keywords: chemotherapy, nausea and vomiting, tropisetron