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Delta-9-Tetrahydrocannabinol as an Antiemetic in Cancer Patients Receiving High-Dose Methotrexate: A Prospective, Randomized Evaluation

ALFRED E. CHANG, M.D.; DAVID J. SHILING, M.D.; RICHARD C. STILLMAN, M.D.; NELSON H. GOLDBERG, M.D.; CLAUDIA A. SEIPP, R.N.; IVAN BAROFSKY, Ph.D.; RICHARD M. SIMON, Ph.D.; and STEVEN A. ROSENBERG, M.D., Ph.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Alfred E. Chang, M.D.; Surgery Branch, National Cancer Institute, Building 10, Room 10N116; Bethesda, MD 20205.


Bethesda, Maryland


Ann Intern Med. 1979;91(6):819-824. doi:10.7326/0003-4819-91-6-819
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Fifteen patients with osteogenic sarcoma receiving high-dose methotrexate chemotherapy were studied in a randomized, double-blind, placebo-controlled trial of oral and smoked delta-9-tetrahydrocannabinol (THC) as an antiemetic. Each patient served as his or her own control. Fourteen of 15 patients had a reduction in nausea and vomiting on THC as compared to placebo. Delta-9-tetrahydrocannabinol was significantly more effective than placebo in reducing the number of vomiting and retching episodes, degree of nausea, duration of nausea, and volume of emesis (P < 0.001). There was a 72% incidence of nausea and vomiting on placebo. When plasma THC concentrations measured < 5.0 ng/mL, 5.0 to 10.0 ng/mL, and > 10.0 ng/mL, the incidences of nausea and vomiting were 44%, 21%, and 6%, respectively. Delta-9-tetrahydrocannabinol appears to have significant antiemetic properties when compared with placebo in patients receiving high-dose methotrexate.

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