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Possible cardiac side effects of granisetron, an antiemetic agent, in patients with bone and soft-tissue sarcomas receiving cytotoxic chemotherapy

  • Original Article
  • Antiemetics, Granisetron, Chemotherapy, Arrhythmia, Vagus Nerve
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Abstract

The cardiac effect of granisetron, a selective 5-hydroxytryptamine3 receptor antagonist, on 12 patients with bone and soft-tissue sarcomas treated by cytotoxic chemotherapy consisting of multiple courses was examined. Of the 12 patients, 4 showed significant electrocardiographical changes, including sinus bradycardia, integral change of P-waves, junctional escape beat, and atrioventricular (AV) block with Wenckebach phenomenon, indicating stimulatory regulation of the vagus nerve. These changes were observed in each patient after several courses of chemotherapy but not in the first course. There was no correlation between the electrocardiographical changes and the chemotherapeutic agents used or the type of tumor present. A patient with osteosarcoma showed persistent bradycardia in three courses, all protocols of which contained high-dose methotrexate. From these findings we conclude that the cardiac responses may be due to stimulated activity of the vagal efferent nerve, which is regulated reflexly by afferent nerve activity suppressed by granisetron. On the other hand, the antiemetic efficacy of granisetron was satisfactory. These results suggest that careful observation of the heart is necessary when granisetron is used, especially for chemotherapy consisting of repeated multiple courses.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Gunma University School of Medicine, 3-39-22 Showa, 371, Maebashi, Gunma, Japan

    Hideomi Watanabe, Tetsuya Shinozaki, Satoru Arita & Masaki Chigira

  2. Second Department of Internal Medicine, Gunma University School of Medicine, 3-39-22 Showa, 371, Maebashi, Gunma, Japan

    Akira Hasegawa

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  1. Hideomi Watanabe
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  2. Akira Hasegawa
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  3. Tetsuya Shinozaki
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  4. Satoru Arita
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  5. Masaki Chigira
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Watanabe, H., Hasegawa, A., Shinozaki, T. et al. Possible cardiac side effects of granisetron, an antiemetic agent, in patients with bone and soft-tissue sarcomas receiving cytotoxic chemotherapy. Cancer Chemother. Pharmacol. 35, 278–282 (1995). https://doi.org/10.1007/BF00689445

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  • DOI: https://doi.org/10.1007/BF00689445

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