Hayashi Toshinobu, Shimokawa Mototsugu, Miyoshi Takanori, Toriyama Yoko, Yokota Chiaki, Taniguchi Jun, Hanada Kiyonori, Tsumagari Kyouichi, Okubo Noriko, Koutake Yoshimichi, Sakata Kohei, Kawamata Yosei, Goto Takashi, Tsurusaki Yasufumi, Koyabu Makiko
Department of Pharmacy, Clinical Research Institute, National Kyushu Medical Center, 1-8-1, Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan.
Department of Pharmacy, National Kyushu Cancer Center, 3-1-1, Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Support Care Cancer. 2017 Sep;25(9):2707-2714. doi: 10.1007/s00520-017-3679-7. Epub 2017 Mar 24.
The incidence of and the risk factors for nausea and vomiting in patients undergoing low emetic risk chemotherapy (LEC) are unclear. The aim of the study was to provide information on these topics by performing a multicenter, observational, prospective study.
The study consisted of patients who were administered first-time LEC that was consistent or inconsistent with current guidelines. Using the visual analog scale, patients recorded their daily food intake and the occurrence and severity of nausea over a 5-day treatment period.
The overall incidence of chemotherapy-induced nausea and vomiting did not differ significantly between patients undergoing guideline-consistent (n = 89) or guideline-inconsistent (n = 121) prophylaxis (30.3 vs. 22.3%, respectively; P = 0.19). Logistic regression analysis identified a history of nausea and LEC other than taxanes as independent risk factors associated with nausea and vomiting in patients undergoing LEC. The mean daily visual analog scale scores for nausea severity and a decrease in food intake were <25 mm throughout the entire observation period.
Guideline-consistent prophylaxis appeared to control nausea and vomiting effectively in patients undergoing LEC. However, patients with a history of nausea and receiving LEC other than taxanes should be carefully observed and treatment should be adjusted according to their symptoms.
低致吐风险化疗（LEC）患者恶心和呕吐的发生率及危险因素尚不清楚。本研究的目的是通过开展一项多中心、观察性、前瞻性研究来提供有关这些主题的信息。
该研究纳入了接受首次LEC且与当前指南一致或不一致的患者。患者使用视觉模拟量表记录其在5天治疗期间的每日食物摄入量以及恶心的发生情况和严重程度。
接受指南一致（n = 89）或指南不一致（n = 121）预防措施的患者中，化疗引起的恶心和呕吐的总体发生率无显著差异（分别为30.3%和22.3%；P = 0.19）。逻辑回归分析确定，恶心病史以及除紫杉烷类以外的LEC是接受LEC患者恶心和呕吐的独立危险因素。在整个观察期内，恶心严重程度的每日视觉模拟量表平均得分和食物摄入量减少均<25 mm。
指南一致的预防措施似乎能有效控制接受LEC患者的恶心和呕吐。然而，有恶心病史且接受除紫杉烷类以外的LEC的患者应仔细观察，并应根据其症状调整治疗。
