Olanzapine and 5-HT3 With or Without Dexamethasone to Prevent CINV

Inclusion criteria

• Patients 18 years of age or older with malignant disease；
• Life expectancy ≥ 3 months;
• Scheduled to receive highly emetogenic chemotherapy；
• Had a European Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2

Exclusion criteria

• There are contraindications to chemotherapy(Absolute number of neutrophils ≤ 1,500/uL, hemoglobin ≤ 90g/L, platelet count ≤ 10000/uL, serum creatinine level ≥ 2.0mg/dl (177 μmol/L), ALT and AST ≥ 2.5 times the upper normal limit, bilirubin ≥ 1.5 times the upper normal limit);
• History of central nervous system disease (e.g., brain metastases or a seizure disorder);
• Severe cognitive impairment；
• Treatment with another antipsychotic agent such as risperidone, quetiapine, clozapine, a phenothiazine, or a butyrophenone within 30 days before enrollment or plans for such treatment during the study period;
• Concurrent use of pharyngeal or abdominal radiotherapy;
• Concurrent use of quinolone antibiotics;
• Concurrent use of Amifostine;
• Chronic alcoholism;
• Known hypersensitivity to olanzapine;
• Know arrhythmia, uncontrolled congestive heart failure or acute myocardial infarction within 6 months;
• Known uncontrolled diabetes mellitus;
• Vomiting or retching 24 hours before chemotherapy;
• Use of anti-emesis drugs 48 hours before chemotherapy;
• Patients who require medication with dexamethasone for pretreatment.