Mika Mizuno1, Masamichi Hiura2, Fumitaka Kikkawa3, Fumitaka Numa4, Nobuo Yaegashi5, Hisashi Narahara6, Daisuke Aoki7, Eizo Kimura8, Hisamori Kato9, Mototsugu Shimokawa10, Toru Sugiyama11, Toshiharu Kamura12. 1. Nagoya University Graduate School of Medicine, Japan. Electronic address: mmizuno@aichi-cc.jp. 2. National Hospital Organization Shikoku Cancer Center, Japan. 3. Nagoya University Graduate School of Medicine, Japan. 4. Tokuyama Central Hospital, Japan. 5. Tohoku University Graduate School of Medicine, Japan. 6. Faculty of Medicine, Oita University, Japan. 7. Keio University School of Medicine, Japan. 8. Kousei General Hospital, Japan. 9. Kanagawa Cancer Center, Japan. 10. National Hospital Organization Kyushu Cancer Center, Japan. 11. Iwate Medical University, Japan. 12. Kurume University School of Medicine, Japan.
Abstract
OBJECTIVE: This study was performed to investigate the occurrence of and risk factors for chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer. METHODS: In total, 214 patients with gynecologic cancer who underwent highly emetogenic (HEC) or moderately emetogenic chemotherapy (MEC) were evaluated. We investigated the relationship between CINV and clinical factors and the accuracy of estimation of CINV by medical staff in the acute and late phases. Vomiting was evaluated in terms of frequency, and nausea was evaluated with a 100-mm visual analog scale on days 1 to 7. We also analyzed the risk factors and changes in CINV over time using a generalized linear mixed (GLM) model. RESULTS: The multivariate analysis revealed no significant risk factors for acute CINV. The independent risk factors for delayed nausea were a morning sickness history (odds ratio [OR], 2.687; 95% confidence interval [95% CI], 1.450-4.976; p=0.0017), age (each 1-year increment) (OR, 0.97; 95% CI, 0.944-0.996; p=0.0235), and HEC (OR, 2.134; 95% CI, 1.039-4.383; p=0.0391). The GLM model demonstrated that the independent factors affecting nausea were significant morning sickness (p=0.0101) and HEC (p=0.0136). These data also showed more severe nausea from days 3 to 5, but the negative predictive value for estimation of delayed nausea by medical staff was 57.8%. CONCLUSION: Our data suggest that improvement of preventive antiemetic administration is needed for patients with risk factors to manage delayed CINV caused by HEC and by MEC.
OBJECTIVE: This study was performed to investigate the occurrence of and risk factors for chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer. METHODS: In total, 214 patients with gynecologic cancer who underwent highly emetogenic (HEC) or moderately emetogenic chemotherapy (MEC) were evaluated. We investigated the relationship between CINV and clinical factors and the accuracy of estimation of CINV by medical staff in the acute and late phases. Vomiting was evaluated in terms of frequency, and nausea was evaluated with a 100-mm visual analog scale on days 1 to 7. We also analyzed the risk factors and changes in CINV over time using a generalized linear mixed (GLM) model. RESULTS: The multivariate analysis revealed no significant risk factors for acute CINV. The independent risk factors for delayed nausea were a morning sickness history (odds ratio [OR], 2.687; 95% confidence interval [95% CI], 1.450-4.976; p=0.0017), age (each 1-year increment) (OR, 0.97; 95% CI, 0.944-0.996; p=0.0235), and HEC (OR, 2.134; 95% CI, 1.039-4.383; p=0.0391). The GLM model demonstrated that the independent factors affecting nausea were significant morning sickness (p=0.0101) and HEC (p=0.0136). These data also showed more severe nausea from days 3 to 5, but the negative predictive value for estimation of delayed nausea by medical staff was 57.8%. CONCLUSION: Our data suggest that improvement of preventive antiemetic administration is needed for patients with risk factors to manage delayed CINV caused by HEC and by MEC.
Authors: Cindy Weinstein; Karin Jordan; Stuart Green; Saleem Khanani; Elizabeth Beckford-Brathwaite; Waldimir Vallejos; Annpey Pong; Stephen J Noga; Bernardo L Rapoport Journal: BMC Cancer Date: 2020-09-25 Impact factor: 4.430