Control of chemotherapy-induced nausea and vomiting in patients with gastrointestinal tumours

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Abstract

Objectives

During cancer treatment, many patients experience chemotherapy-induced nausea and vomiting (CINV), which leads to a lower quality of life and poorer adherence to the subsequent chemotherapy cycles. The aim of the study was to assess antiemetic therapy prescribing and CINV control in the acute phase (24 hours post-chemotherapy) and the delayed phase (days 2–4 post-chemotherapy). Factors influencing CINV control were also determined.

Methods

Information on antiemetic premedication was gathered from patient medical records. Data regarding antiemetic therapy post-discharge and CINV control were in both phases obtained using patient questionnaires. Antiemetic therapy prescribing was compared with internal CINV prevention and control guidelines. Predictive factors for CINV control were evaluated using binary logistic regression.

Results

There were 62 patients enrolled in the study, out of which 50 (80.6%) received adequate antiemetic premedication. In the acute phase, 46 (74.2%) patients reported well-controlled CINV, whereas 16 (25.8%) reported uncontrolled CINV. None of the patients was prescribed post-discharge antiemetic therapy as per guidelines. In the delayed phase, CINV was more frequent as 39 (62.9%) patients reported well-controlled CINV, whereas uncontrolled CINV was reported in 23 (37.1%) patients. The predictive factors for overall CINV control were prescription of corticosteroids (OR=9.025, p=0.019) and patient age (OR=0.851, p=0.002). The delayed CINV control was dependent on age (OR=0.885, p=0.030) and acute CINV control (OR=17.377, p=0.001).

Conclusions

The majority of the patients were prescribed adequate antiemetic therapy for the acute phase but not for the delayed phase, which may have resulted in more patients experiencing delayed CINV.

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