Endogenous cortisol exerts antiemetic effect similar to that of exogenous corticosteroids
1993

Cortisol's Role in Reducing Chemotherapy-Induced Nausea

Sample size: 42 publication Evidence: moderate

Author Information

Author(s): T.J. Hurstil, M. Fredrikson, G. Steineck, S. Bdrjeson, C.J. Fiirst, C. Peterson

Primary Institution: Karolinska Institute and Karolinska Hospital

Hypothesis

Does endogenous cortisol secretion affect the severity of cisplatin-induced nausea and vomiting in ovarian cancer patients?

Conclusion

Lower levels of cortisol before chemotherapy are linked to more severe nausea and vomiting, while dexamethasone helps only those with low cortisol levels.

Supporting Evidence

  • Patients with lower cortisol excretion had more emetic episodes.
  • Patients receiving dexamethasone had reduced nausea if they had low cortisol levels.
  • The study was double-blinded to minimize bias.
  • Mean cortisol excretion was significantly different between groups receiving dexamethasone and placebo.

Takeaway

If your body makes less cortisol before chemotherapy, you might feel more sick. Giving a medicine called dexamethasone helps some people feel better.

Methodology

Patients were randomized to receive ondansetron with either dexamethasone or placebo, and their cortisol levels were measured through urine samples.

Potential Biases

The study was double-blinded, reducing the risk of bias in treatment assignment.

Limitations

The study only included ovarian cancer patients, which may limit the generalizability of the findings.

Participant Demographics

Mean age of participants was 53.6 years, with a range of 39-74.

Statistical Information

P-Value

0.009

Confidence Interval

1.9 (0.8 - 4.6) for emetic episodes in ondansetron and placebo group

Statistical Significance

p=0.009

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