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Nausea and vomiting during the first 3 intercycle periods in chemo-naive cancer patients receiving moderately/highly emetogenic therapy

Abstract

Aims and background

There is a paucity of data regarding the incidence, intensity, and treatment of nausea and vomiting during the intercycle periods of chemotherapy (CHT). The aims of the study were to assess the incidence and intensity of intercycle nausea and vomiting, to assess the use of rescue antiemetic medications, and to define the more uncomfortable symptom between nausea and vomiting.

Methods

In a prospective study, 108 chemotherapy-naive patients treated with highly or moderately emetogenic CHT for different primary cancers were enrolled. All patients filled out the Edmonton Symptom Assessment System tool before the first cycle of CHT (T0) and on 14-16 days thereafter for the first 3 cycles of CHT (i.e., T1, T2, T3).

Results

Sixty-seven patients completed the study. During CHT administration, all patients received antiemetics according to international guidelines. During the intercycle periods, nausea was reported in 6.0% of patients at T0, 10.5% at T1, and 26.9% at T2 and T3, respectively. The intensity of nausea was mild for 6.0%, 21%, and 18% of patients at T1, T2, and T3, respectively; moderate for 1.5%, 3.0%, and 6.0% at T1 to T3; and severe in only 3.0% of patients at any time. Vomiting was present in 1.5% and 10.5% of patients at T2 and T3. Rescue antiemetic medication was required for 41.8% at T1, 53% at T2, and 47.8% at T3. At the end of the study, 70.1% of patients described nausea as the more uncomfortable symptom compared to vomiting.

Conclusions

Nausea has a higher burden of impact over vomiting and should be assessed and treated separately throughout multiple cycles of CHT.

Tumori 2015; 101(6): 692 - 696

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000351

Authors

Maria Adelaide Pessi, Andrea Necchi, Paolo Bossi, Carlo Resteghini, Patrizia Giannatempo, Laura Ferrari, Nicoletta Zilembo, Carla Ida Ripamonti

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Supportive Care in Cancer Unit, Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano - Italy
  • Medical Oncology 1 Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano - Italy
  • Head and Neck Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano - Italy
  • Medical Day Hospital Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano - Italy

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