Supportive Care in Cancer

, Volume 25, Issue 11, pp 3457–3464 | Cite as

Longitudinal perceptions of the side effects of chemotherapy in patients with gynecological cancer

  • Hui-Chun Hsu
  • Su-Yu Tsai
  • Shang-Liang Wu
  • Shiow-Roug Jeang
  • Mei-Yao Ho
  • Wen-Shiung Liou
  • An-Jen ChiangEmail author
  • Tsung-Hsien Chang
Original Article



This study aimed to assess the incidence and difference of side effects among six courses of chemotherapy (C/T) in gynecological cancer patients.


The study period was from Sep. 2010 to Dec. 2011 at the Kaohsiung Veterans General Hospital in Taiwan. The treating protocols, courses, and drugs of C/T in patient were considered according to the different malignant cancers and clinical conditions. The patient data of age, marriage status, education, religion, and experiences of C/T were collected. The patients’ or their families’ reported side effects of C/T were recorded daily from the beginning of C/T to the 10th day after C/T in each cycle and every course of C/T.


Total 89 patients enrolled into the study received total 450 courses of C/T. The mean age was 54.52 ± 11.02. Ovarian cancer was the most common malignant disease (64.0%). The most often combination of drugs used was Taxol and carboplatin (40.9%). Patients complained peripheral numbness of limbs, with the highest incidence of 58.6%. The side effects with incidence about 50% were decreased fatigue (55.0%) and hair loss (49.9%). Other side effects with different levels of incidence were also noticed, such as lack of appetite, changes in taste, and muscle ache. The incidences of peripheral limb numbness and hair loss were increased with following courses of C/T. The high incidence of fatigue did not show variation between different courses of C/T.


This study revealed the incidence of side effects and occurrence timing during C/T in patients with gynecological cancer. These data provide substantial information to patients and their families to understand the potential side effects of C/T courses, which might increase their compliance in receiving adjuvant C/T. Relieving the side effects in C/T would be important to improve their quality of daily life and treatment willingness.


Gynecological cancer Chemotherapy Side effects Peripheral neuropathy CIPN 



The study was supported by grants from Kaohsiung Veterans General Hospital, Taiwan (VGHKS103-086), and Veterans General Hospital—National Sun Yat-Sen University (VGHNSU103-006), Taiwan.

Compliance with ethical standards

Ethical approval for this study was obtained from the KSVGH Institutional Review Board.


Hui-Chun Hsu received research funding (VGHKS103-086 and VGHNSU103-006) from Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    American Cancer Society (2015) Cancer facts and figures 2015. American Cancer Society, AtlantaGoogle Scholar
  2. 2.
    Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI). SEER cancer statistics factsheets: Cervix uteri cancer. Available at: Accessed 29 Sept 2014
  3. 3.
    SEER, NCI. SEER cancer statistics factsheets: endometrial cancer. Available at: Accessed 29 Sept 2014
  4. 4.
    SEER, NCI. SEER cancer statistics factsheets: ovary cancer. Available at: Accessed 29 Sept 2014
  5. 5.
    SEER, NCI. SEER cancer statistics factsheets: vulvar cancer. Available at: Accessed 29 Sept 2014
  6. 6.
    Surveillance, Epidemiology, and End Results (SEER) (2013) Program of Ministry of Health and Welfare, Taiwan, 2013. Available at:
  7. 7.
    Gloeckler Ries LA et al (2013) Cancer survival and incidence from the Surveillance, Epidemiology, and End Results (SEER) program. Oncologist 8(6):541–552CrossRefGoogle Scholar
  8. 8.
    Sun CC, Ramirez PT, Bodurka DC (2007) Quality of life for patients with epithelial ovarian cancer. Nat Clin Pract Oncol 4(1):18–29CrossRefGoogle Scholar
  9. 9.
    Seretny M et al (2014) Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. PAIN® 155(12):2461–2470CrossRefGoogle Scholar
  10. 10.
    Mock V, Atkinson A, Barsevick A, Cella D, Cimprich B, Cleeland C et al (2000) NCCN practice guidelines for cancer-related fatigue. Oncology (Williston Park) 14:151–161Google Scholar
  11. 11.
    Cella D, Davis K, Breitbart W, Curt G (2001) Fatigue coalition. Cancer-related fatigue: prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. J Clin Oncol 19:3385–3391CrossRefGoogle Scholar
  12. 12.
    Ruffer JU, Flechtner H, Tralls P, Josting A, Sieber M, Lathan B et al (2003) Fatigue in long-term survivors of Hodgkin’s lymphoma; a report from the German Hodgkin Lymphoma Study Group (GHSG). Eur J Cancer 39:2179–2186CrossRefGoogle Scholar
  13. 13.
    Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ et al (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol 34(3 Suppl 2):4–12PubMedGoogle Scholar
  14. 14.
    Lou Y, Yates P, McCarthy A, Wang H (2013) Fatigue self-management: a survey of Chinese cancer patients undergoing chemotherapy. J Clin Nurs 22(7–8):1053–1065CrossRefGoogle Scholar
  15. 15.
    Shields K, Craig C, Baxter L, Renda L, Pipe J, Monk B, Chase D (2015) Cancer-related fatigue in gynecologic oncology patients undergoing chemotherapy. Gynecol Oncol 137(3):596CrossRefGoogle Scholar
  16. 16.
    Wang SC, Borison HL (1950) The vomiting center: a critical experimental analysis. Arch Neurol Psychiatr 63:928–941CrossRefGoogle Scholar
  17. 17.
    Miller AD, Wilson VJ (1983) “Vomiting center” reanalyzed: an electrical stimulation study. Brain res 270:154–158CrossRefGoogle Scholar
  18. 18.
    Schmoll HJ, Aapro MS, Poli-Bigelli S et al (2006) Comparison of an aprepitant regimen with a multiple-day ondansetron regimen, both with dexamethasone, for antiemetic efficacy in high-dose cisplatin treatment. Ann Oncol 17:1000–1006CrossRefGoogle Scholar
  19. 19.
    Pater JL, Lofters WS, Zee B et al (1997) The role of the 5-HT3 antagonists ondansetron and dolasetron in the control of delayed onset nausea and vomiting in patients receiving moderately emetogenic chemotherapy. Ann Oncol 8:181–185CrossRefGoogle Scholar
  20. 20.
    Paul J, Hesketh N (2008) Chemotherapy-induced nausea and vomiting. Engl J Med 358:2482–2494CrossRefGoogle Scholar
  21. 21.
    Kris MG et al (2006) American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 24(18):2932–2947CrossRefGoogle Scholar
  22. 22.
    Gralla RJ, Osoba D, Kris MG et al (1999) Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines. American Society of Clinical Oncology. J Clin Oncol 17:2971–2994CrossRefGoogle Scholar
  23. 23.
    Jordan K, Schmoll HJ, Aapro MS (2007) Comparative activity of antiemetic drugs. Crit Rev Oncol Hematol 61:162–175CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Hui-Chun Hsu
    • 1
    • 2
  • Su-Yu Tsai
    • 1
  • Shang-Liang Wu
    • 3
  • Shiow-Roug Jeang
    • 1
  • Mei-Yao Ho
    • 2
  • Wen-Shiung Liou
    • 4
    • 5
    • 6
  • An-Jen Chiang
    • 4
    • 5
    • 6
    • 7
    Email author
  • Tsung-Hsien Chang
    • 8
  1. 1.Department of NursingKaohsiung Veterans General HospitalKaohsiungTaiwan
  2. 2.Health Care and the University of Technology Graduate School of The Meiho UniversityPingtungTaiwan
  3. 3.Environment and Population HealthGriffith UniversityNathanAustralia
  4. 4.Department of Obstetrics and GynecologyKaohsiung Veterans General HospitalKaohsiungRepublic of China
  5. 5.Institute of Biomedical SciencesNational Sun Yat-Sen UniversityKaohsiungTaiwan
  6. 6.Department of Obstetrics and GynecologyNational Defense Medical CenterTaipeiTaiwan
  7. 7.Department of Obstetrics and GynecologyNational Yang-Ming UniversityTaipeiTaiwan
  8. 8.Department of Medical Education and ResearchKaohsiung Veterans General HospitalKaohsiungTaiwan

Personalised recommendations