Chemotherapy-induced nausea and vomiting—incidence and impact on patient quality of life at community oncology settings
- 1.5k Downloads
Goals of work
The present study sought to determine the prevalence of acute and delayed chemotherapy-induced nausea and vomiting (CINV) across ten community oncology settings. The effect of CINV on quality of life (QOL) was also evaluated.
Materials and methods
Cancer patients who were scheduled for their first cycle of a new chemotherapy regimen were recruited from ten community oncology clinics. Study participants recorded occurrence of CINV by completing a daily diary each day for the first 8 days after treatment during each cycle and the Functional Living Index-Emesis (FLIE) before chemotherapy, at the end of day 1 and day 6 after chemotherapy. Mixed model regression analysis was used to explore the association between occurrence of CINV at cycle 1 and subsequent cycles and its impact on patient QOL.
One hundred and fifty-one patients provided information for at least one cycle. During cycle 1, only 33% had neither acute nor delayed CINV. Of the 36% patients who developed acute CINV, 8% developed acute CINV only. Of the 59% who developed delayed CINV, 53% reported delayed only and 47% reported acute and delayed CINV. A similar pattern was seen at cycles 2 and 3. Experience of CINV at cycle 1 was associated with the development of CINV at cycles 2 and 3. Occurrence of CINV significantly interfered with patient QOL as assessed by the FLIE.
CINV remained a substantial problem for patients receiving chemotherapy in this community-based sample, especially delayed CINV. CINV significantly interfered with patient QOL and daily functioning.
KeywordsNausea Vomiting Quality of life Chemotherapy Cancer
This research was supported by a grant from Merck & Co., Inc.
- 2.De Mulder PH, Seynaeve C, Vermorken JB, van Liessum PA, Mols-Jevdevic S, Allman EL, Beranek P, Verweij J (1990) Ondansetron compared with high-dose metoclopramide in prophylaxis of acute and delayed cisplatin-induced nausea and vomiting. A multicenter, randomized, double-blind, crossover study. Ann Intern Med 113:834–840PubMedGoogle Scholar
- 4.Gandara DR (1991) Progress in the control of acute and delayed emesis induced by cisplatin. Eur J Cancer 27(suppl):9–11Google Scholar
- 6.Gralla RJ, Osoba D, Kris MG, Kirkbride P, Hesketh PJ, Clark-Snow R, Gill DP, Groshen S, Grunberg S, Koeller JM, Morrow GR, Perez EA, Silber JH, Pfister DG (2000) Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines. American Society of Clinical Oncology. J Clin Oncol 17(9):2971–2994Google Scholar
- 10.Hesketh PJ, Harvey WH, Harker WG, Beck TM, Ryan T, Bricker LJ, Kish JA, Murphy WK, Hainsworth JD, Haley B (1994) A randomized, double-blind comparison of intravenous ondansetron alone and in combination with intravenous dexamethasone in the prevention of high-dose cisplatin-induced emesis. J Clin Oncol 12:596–600PubMedGoogle Scholar
- 12.Hickok JT, Roscoe JA, Morrow GR, King DK, Atkins JN, Fitch TR (2003) Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5-hydroxytryptamine-3 antiemetics: a University of Rochester James P. Wilmot Cancer Center Community Clinical Oncology Program Study of 360 cancer patients treated in the community. Cancer 97:2880–2886PubMedCrossRefGoogle Scholar
- 13.International (Perugia) Consensus on Antiemetic Therapy (1988) Antiemetic Subcommittee of the Multinational Association of Supportive Care in Cancer. Support Care Cancer 6:197–261Google Scholar
- 14.Italian Group for Antiemetic Research (1994) Cisplatin-induced delayed emesis: pattern and prognostic factors during three subsequent cycles. Ann Oncol 5:585–589Google Scholar
- 18.Martin AR, Pearson J, Cai B, Elmer M, Horgan K, Lindley C (2000) Validation of a 5-day recall version of the Functional Living Index-Emesis (FLIE) quality of life questionnaire for chemotherapy-induced emesis. Qual Life Res 9(3):P-18Google Scholar
- 19.Marty M, Pouillart P, Scholl S, Droz JP, Azab M, Brion N, Pujade-Lauraine E, Paule B, Paes D, Bons J (1990) Comparison of the 5-hydroxytryptamine 3 (serotonin) antagonist ondansetron (GR 38032F) with high-dose metoclopramide in the control of cisplatin-induced emesis. N Engl J Med 322:816–821PubMedCrossRefGoogle Scholar
- 23.No authors listed (1997) NCCN antiemesis practice guidelines. Oncology (Williston Park) 11:57–89Google Scholar
- 25.Roila F, Boschetti E, Tonato M, Basurto C, Bracarda S, Picciafuoco M, Patoia L, Santi E, Penza O, Ballatori E et al (1991) Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone. A randomized single-blind study. Am J Clin Oncol 14:238–242PubMedCrossRefGoogle Scholar
- 27.Voliotis DL, Diehl V (1998) Clinical aspects and prognostic factors of nausea and vomiting after chemotherapy. In: DiCato MA (ed) Medical management of cancer treatment induced emesis. Martin Dunitz, Philadelphia, pp 45–54Google Scholar