Molassiotis A, Saunders M P, Valle J, Wilson G, Lorigan P, Wardley A, Levine E, Cowan R, Loncaster J, Rittenberg C
School of Nursing, Midwifery and Social Work, University of Manchester, Coupland III, Manchester, UK.
Support Care Cancer. 2008 Feb;16(2):201-8. doi: 10.1007/s00520-007-0343-7. Epub 2007 Oct 10.
The aim of the study was to assess levels of chemotherapy-induced nausea and vomiting (CINV) in routine practice.
The study was an observational prospective evaluation using patient self-reports. One hundred and two patients with cancer in a single cancer centre in UK receiving their first chemotherapy treatment participated in the study and were followed up over four cycles, providing a total of 272 assessments of nausea and vomiting. Data was collected with the use of the MASCC Antiemesis Tool (MAT), which is an eight-item short clinical scale assessing acute and delayed nausea and vomiting after chemotherapy.
Results indicated that acute vomiting was experienced by 15.7% of the patients in cycle 1 and delayed vomiting by 14.7%, while acute nausea was present in 37.3% of the patients and delayed nausea in 47.1%, increasing over the subsequent cycles. Moderately emetogenic and highly emetogenic chemotherapy had the highest incidence of CINV, whereas patients receiving highly emetogenic chemotherapy showed significant levels of delayed nausea. Acute symptoms were more easily controlled than delayed symptoms.
The data suggest that, while vomiting is well controlled, nausea remains a significant problem in practice, and optimal management of CINV is yet to be achieved. Understanding more clearly the biological basis of nausea will assist in managing this complex symptom more effectively in practice.
本研究旨在评估常规实践中化疗引起的恶心和呕吐(CINV)水平。
本研究是一项采用患者自我报告的观察性前瞻性评估。英国一个癌症中心的102例首次接受化疗的癌症患者参与了本研究,并进行了四个周期的随访,共提供了272次恶心和呕吐评估。使用MASCC止吐工具(MAT)收集数据,该工具是一个包含八个条目的简短临床量表,用于评估化疗后急性和延迟性恶心和呕吐。
结果表明,第1周期中15.7%的患者经历了急性呕吐,14.7%的患者经历了延迟性呕吐,而37.3%的患者存在急性恶心,47.1% 的患者存在延迟性恶心,且在随后的周期中有所增加。中度致吐性和高度致吐性化疗的CINV发生率最高,而接受高度致吐性化疗的患者延迟性恶心水平显著。急性症状比延迟症状更容易控制。
数据表明,虽然呕吐得到了很好的控制,但恶心在实践中仍然是一个重大问题,CINV的最佳管理尚未实现。更清楚地了解恶心的生物学基础将有助于在实践中更有效地管理这一复杂症状。