Radiation Sickness: An Analysis of Over 1000 Controlled Drug Trials
In 1042 irradiated patients drug trials were conducted in attempts to assess the relative value of central sedatives (mainly phenothiazines) as compared with pyridoxine and a relatively inert group of drugs. The phenothiazines used were of the older type (chlorpromazine, prochlorperazine, thiopropazate, fluopromazine, pecazine) as well as of the newer type (trifluoperazine, haloperidol). The relatively inert drugs included cyclazine, amphetamine, diphenylhydramine, and lactose. For nausea, the predominant symptom, pyridoxine, the older phenothiazines, and the newer tranquilizer groups are all significantly superior to the inert drugs. The newer tranquilizers are superior to all others, but there is no statistical difference between pyridoxine and the older phenothiazines in the relief of nausea. For vomiting and listlessness, a similar superiority of the newer tranquilizers is shown. In the case of anorexia, however, pyridoxine and the older phenothiazines are superior to the inert group but the newer tranquilizers are relatively less effective. For all drugs used in radiation sickness, anorexia is the most difficult symptom to relieve possibly because its control lies in the appetite center, separate from the vomiting center. Possibly some other factor also enters into its control, such as the loss of taste. Haloperidol and trifluoperazine assessed separately showed no statistical difference in their relative efficacy in any symptom including anorexia. Radiation of the abdomen and pelvis causes more severe radiation sickness, and inert drugs give, in general, less relief of symptoms arising from radiation of this area than of other parts. All the drugs were less efficacious when radiation is given to the abdomen and pelvis, although not at a significantly statistical level. In comparison of the efficacy of each group for irradiation both above and below the diaphragm, the newer tranquilizers appear significantly superior to all others. For nausea arising in 265 cases of breast irradiation, the new tranquilizers are significantly superior to all others. Anorexia after irradiation may originate in the appetite center or have a different cause such as delayed gastric emptying. Separate origins for vomiting and for anorexia may account for the superior effect noted with the newer tranquilizers on the symptoms of nausea and vomiting and the greatly inferior effect on anorexia. The tranquilizers may act by sedating the vomiting center. Evidence was found for a specific deficiency of pyridoxine in some cases of radiation sickness. Whether this is a direct effect on enzymes, an effect on the bowel, or a result of metabolic changes associated with vomiting is uncertain. Nevertheless pyridoxine may be of value even if other anti-emetic drugs fail to control the symptoms of radiation sickness.
- Research Organization:
- Peter MacCallum Clinic, Melbourne
- NSA Number:
- NSA-17-005918
- OSTI ID:
- 4738122
- Journal Information:
- Brit. Med. J., Vol. Vol: 2; Other Information: Orig. Receipt Date: 31-DEC-63
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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