SIGNIFICANCE OF THE INSTITUTIONAL ANTIEMETIC GUIDELINES FOR CHEMOTHERAPY INDUCED NAUSEA AND VOMITING: EVALUATION OF EFFICACY AND COSTS

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Abstract

Purpose

Chemotherapy-induced nausea and vomiting (CINV) is one of the major adverse events in patients receiving cancer chemotherapy. Preventing CINV is the key to maintaining a patient's quality of life. At Oita University Hospital, the antiemetic regimen was standardized based on the antiemetic guidelines for CINV published by the Japanese of Society Clinical Oncology (JSCO) in May 2010. In the present study, we retrospectively evaluated the clinical and economic effects of standardizing the antiemetic regimen.

Methods

Palonosetoron, dexamethasone aprepitant, was administered as antiemetics according to the newly standardized regime. The efficacy and costs of antiemetic treatment of chemotherapy before and after standardization of the antiemetic regimen between July 2010 and December 2010 were compared between patients receiving high-grade emetogenic chemotherapy (HEC) and those receiving moderate-grade emetogenic chemotherapy (MEC). The efficacy was evaluated by the proportion of patients without nausea (Results

A total of 50 and 38 patients were treated by the HEC and MEC regimens, respectively. In the HEC group, the proportion of patients without nausea (90.0% versus 92.0%) and complete response (89.0% versus 92.0%) were not significantly different between before and after the standardization. In the MEC group, the proportion of patients without nausea after the standardization was significantly higher than that before the standardization (94.7% and 76.7%, respectively, P < 0.05), but complete response was not different. The costs of antiemetics after the standardization were significantly lower compared with those before the standardization (\16 002 664 versus \17 550 764, respectively, P < 0.01).

Conclusion

Using the standardized antiemetic treatment may help reduce the nausea or vomiting suffered by patients receiving cancer chemotherapy and will be less of a financial burden to these patients.

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