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. 2018 Oct 4:10:4249-4255.
doi: 10.2147/CMAR.S176574. eCollection 2018.

Risk factors for delayed chemotherapy-induced nausea and vomiting with low-emetic-risk chemotherapy: a prospective, observational, multicenter study

Toshinobu Hayashi  1   2 , Mototsugu Shimokawa  3 , Koichi Matsuo  2 , Takanori Miyoshi  4 , Yoko Toriyama  4 , Chiaki Yokota  5 , Jun Taniguchi  6 , Kiyonori Hanada  7 , Kyouichi Tsumagari  8 , Noriko Okubo  9 , Yoshimichi Koutake  10 , Kohei Sakata  11 , Yosei Kawamata  12 , Takashi Goto  13 , Yasufumi Tsurusaki  14 , Makiko Koyabu  1
Affiliations

Risk factors for delayed chemotherapy-induced nausea and vomiting with low-emetic-risk chemotherapy: a prospective, observational, multicenter study

Toshinobu Hayashi et al. Cancer Manag Res. .

Abstract

Purpose: Improvement in the control of delayed chemotherapy-induced nausea and vomiting (CINV) is needed. There is limited information on antiemetic prophylaxis for patients undergoing low-emetic-risk chemotherapy (LEC), and the optimal antiemetic treatment is not well understood. Therefore, we analyzed the risk factors for delayed CINV to aid in the development of individualized treatments.

Patients and methods: This prospective multicenter study was conducted in 13 hospitals and included patients with solid cancers undergoing LEC. A total of 222 patients were enrolled between September 2013 and November 2014. The participants completed a daily diary for 5 days after the commencement of the first cycle of LEC to describe the daily incidence of CINV (yes/no). Furthermore, the participants described the severity of nausea and the amount of food intake with the help of VAS.

Results: Two hundred and ten patients provided their data that were analyzed using multivariate logistic regression to examine the risk factors for delayed CINV. History of CINV, Eastern Cooperative Oncology Group performance status score ≥1, acute CINV, and single-day antiemetic prophylaxis were identified as independent risk factors for delayed CINV.

Conclusion: The current use of antiemetic prophylaxis according to the recommended guideline appears to effectively control delayed CINV in patients undergoing LEC. Therefore, patients with the abovementioned risk factors should be carefully observed, and their treatment should be adjusted according to their symptoms. The use of multiple-day dexamethasone may be beneficial for those patients who develop acute CINV, especially when it is accompanied by anorexia.

Keywords: adverse effects; antiemetics; prophylaxis; quality of life.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Enrollment of patients. Notes: A total of 222 patients were registered, and 211 patients’ diaries were paired with the case report forms and staff reports. One patient who had an incomplete diary was excluded from the analysis; hence, the data of 210 patients (94.6% of all patients registered) were finally analyzed.
Figure 2
Figure 2
Severity of nausea. Notes: Daily mean visual analog scale (VAS) scores for severity of nausea on days 1–5 after the initiation of low-emetic-risk chemotherapy in patients (A) with and (B) without acute chemotherapy-induced nausea and vomiting. The difference in the severity of nausea is shown between the single- and multiple-day antiemetic prophylaxis groups. VAS (100 mm, worst nausea; 0 mm, no nausea).
Figure 3
Figure 3
Food intake. Notes: Daily mean visual analog scale (VAS) scores for food intake during the first 5 days after the initiation of low-emetic-risk chemotherapy in patients (A) with and (B) without acute chemotherapy-induced nausea and vomiting. The difference in VAS-rated food intakes between the single- and multiple-day antiemetic prophylaxis groups is shown. VAS (100 mm, no oral food intake; 0 mm, eating as usual).
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