Testing the effectiveness of antiemetic guidelines: results of a prospective registry by the CINV Study Group of Japan

Background Many cancer patients suffer from the common side effect of chemotherapy-induced nausea and vomiting (CINV). Guidelines recommend a combination of two prophylactic antiemetics for moderately emetogenic chemotherapy (MEC) and three for highly emetogenic chemotherapy (HEC) and certain MEC re...

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Bibliographic Details
Published in:International journal of clinical oncology 2015-10, Vol.20 (5), p.855-865
Main Authors: Tamura, Kazuo, Aiba, Keisuke, Saeki, Toshiaki, Nakanishi, Yoichi, Kamura, Toshiharu, Baba, Hideo, Yoshida, Kazuhiro, Yamamoto, Nobuyuki, Kitagawa, Yuko, Maehara, Yoshihiko, Shimokawa, Mototsugu, Hirata, Koichi, Kitajima, Masaki
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antiemetics - therapeutic use
Antineoplastic Agents - adverse effects
Cancer
Cancer Research
Chemotherapy
Drug Therapy, Combination
Female
Guidelines
Humans
Japan
Male
Medicine
Medicine & Public Health
Middle Aged
Nausea - chemically induced
Nausea - drug therapy
Neoplasms - drug therapy
Oncology
Original Article
Practice Guidelines as Topic
Registries
Side effects
Surgical Oncology
Vomiting - chemically induced
Vomiting - drug therapy
Young Adult
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Summary:Background Many cancer patients suffer from the common side effect of chemotherapy-induced nausea and vomiting (CINV). Guidelines recommend a combination of two prophylactic antiemetics for moderately emetogenic chemotherapy (MEC) and three for highly emetogenic chemotherapy (HEC) and certain MEC regimens. Methods This multicenter, prospective, observational study analyzed data for 1,910 patients in Japan scheduled for MEC or HEC. Use of antiemetic prophylaxis in relation to type of chemotherapy, incidences of and risk factors for nausea, vomiting, and acute versus delayed CINV, and estimated incidence of CINV by staff were analyzed using Fisher’s exact test and multivariate logistic regression. The patients recorded the incidence of CINV and severity of nausea by visual analogue scales daily for 7 days after receiving chemotherapy. Results A total of 240 (20.1 %) HEC and 476 MEC patients (66.6 %) received 2 antiemetics, compared with 883 (73.9 %) and 200 (28.0 %), respectively, who received 3 antiemetics. Approximately 74 % of HEC and 95 % of MEC patients received antiemetic therapy in compliance with guidelines. Acute nausea and vomiting were well controlled, but high incidences of delayed nausea occurred in both HEC and MEC patients. Delayed vomiting ( p  
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-015-0786-7