Poon Ken Shing Ho, Un Man Kit, Low Xiu Hui, Cheung Yin Ting, Yap Kevin Yi-Lwern, Chan Alexandre
Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore; Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
Pharmacoepidemiol Drug Saf. 2013 Dec;22(12):1345-51. doi: 10.1002/pds.3516. Epub 2013 Sep 10.
Cancer-related fatigue (CRF) has been suggested to be associated with the occurrence of chemotherapy-induced nausea and vomiting (CINV). This study aims to evaluate the potential of CRF in predicting the occurrence of CINV.
This is a prospective, observational study. Recruited patients received moderately to highly emetogenic single-day chemotherapy regimens. On the day of chemotherapy, patients were instructed to provide a score (Likert scale of 0-10) to describe how CRF interfered with his or her ability to engage in daily activities and a score for how severe it was. Patients were then given a standardized 5-day diary to document their CINV events.
A total of 473 eligible patients (median age: 55 years, interquartile range (IQR): 48-61 years) were recruited, with most of the patients diagnosed with gastrointestinal (45%) and breast (37%) cancers. The median score of fatigue interference was 3 (IQR: 0-5). After confounders were adjusted for, patients with low fatigue interference scores (≤3) were more likely to achieve complete protection (no nausea, no vomiting, and no breakthrough antiemetics) of CINV (adjusted odds ratio = 1.57, 95%CI [1.05, 2.35], p = 0.027).
This is the largest study to date to evaluate the association between CRF and CINV. Patients experiencing CRF possessed a higher risk of poor control for CINV.
癌症相关疲劳（CRF）被认为与化疗引起的恶心和呕吐（CINV）的发生有关。本研究旨在评估CRF预测CINV发生的可能性。
这是一项前瞻性观察研究。招募的患者接受中度至高度致吐性单日化疗方案。在化疗当天，患者被要求给出一个分数（0-10的李克特量表）来描述CRF对其参与日常活动能力的干扰程度以及其严重程度。然后给患者一份标准化的5天日记，以记录他们的CINV事件。
共招募了473名符合条件的患者（中位年龄：55岁，四分位间距（IQR）：48-61岁），大多数患者被诊断为胃肠道癌（45%）和乳腺癌（37%）。疲劳干扰的中位分数为3（IQR：0-5）。在对混杂因素进行调整后，疲劳干扰分数低（≤3）的患者更有可能实现CINV的完全保护（无恶心、无呕吐且无突破性使用止吐药）（调整后的优势比=1.57，95%CI[1.05，2.35]，p=0.027）。
这是迄今为止评估CRF与CINV之间关联的最大规模研究。经历CRF的患者对CINV控制不佳的风险更高。
