Risk factors for nausea and vomiting requiring the daily administration of 5-HT3 receptor antagonists in radiotherapy combined with temozolomide for high-grade glioma

• Published in: Nagoya journal of medical science 2024-05, Vol.86 (2), p.304-313
• Main Authors: Takagi, Mai, Sagara, Atsunobu, Kumakura, Yasuo, Watanabe, Minako, Inoue, Rikako, Miyazaki, Masayuki, Ohka, Fumiharu, Motomura, Kazuya, Natsume, Atsushi, Wakabayashi, Toshihiko, Saito, Ryuta, Yamada, Kiyofumi
• Format: Article
• Language: English
• Subjects: Original Paper
• ISSN: 0027-7622; 2186-3326
• DOI: 10.18999/nagjms.86.2.304

Radiotherapy combined with temozolomide (TMZ+RT) is the primary treatment for high-grade glioma. TMZ is classified as a moderate emetic risk agent and, thus, supportive care for nausea and vomiting is important. In Nagoya University Hospital, all patients are treated with a 5-hydroxy-tryptamine 3 receptor antagonist (5-HT 3 RA) for the first 3 days. The daily administration of 5-HT 3 RA is resumed after the 4th day based on the condition of patients during TMZ+RT. Therefore, the present study investigated risk factors for nausea and vomiting in patients requiring the daily administration of 5-HT 3 RA. Patients with high-grade glioma who received TMZ+RT between January 2014 and December 2019 at our hospital were included. Patients were divided into two groups: a control group (patients who did not resume 5-HT 3 RA) and resuming 5-HT 3 RA group (patients who resumed 5-HT 3 RA after the 4th day), and both groups were compared to identify risk factors for nausea and vomiting during TMZ+RT. There were 78 patients in the control group (68%) and 36 in the resuming 5-HT 3 RA group (32%). A multivariate analysis of patient backgrounds in the two groups identified age