Department of Public Health and Pediatrics, University of Torino, Torino, Italy.
Direction of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
Tumori. 2021 Dec;107(6):571-577. doi: 10.1177/0300891621990434. Epub 2021 Feb 3.
Chemotherapy-induced nausea, vomiting, and retching (CINVR) remains a common side effect of treatment. Most previous studies have focused on vomiting control; nausea and retching have been less explored. This study aimed at describing the incidence, severity, and impact on daily life (IDL) of CINVR in the acute (0-24 hours), delayed (>24-120 hours), and overall (0-120 hours) postchemotherapy periods and beyond 120 hours (until next chemotherapy administration); and the pharmacologic and nonpharmacologic strategies adopted by patients to relieve symptoms.
This was a single-center, cross-sectional study of 60 patients undergoing chemotherapy. Participants reported the frequency, severity, and IDL of CINVR from the day of chemotherapy administration up to 120 hours thereafter and nausea and vomiting that occurred beyond 120 hours, as well as pharmacologic and nonpharmacologic remedies used.
Forty-seven (78.3%, 95% confidence interval [CI] 66.4-86.9), 37 (61.7%, 95% CI 49.0-72.9), and 35 (58.3%, 95% CI 45.7-69.9) patients reported no nausea (Numeric Rating Scale ⩽1), vomiting, or retching in the acute, delayed, and overall periods, respectively. Nausea was more frequent, more severe, and had a greater IDL than did vomiting and retching across the overall observation period; beyond 120 hours, 11 (18.3%, 95% CI 10.6-29.9) patients reported nausea and none reported vomiting, with a median IDL of 1/10 (interquartile range: 0.75-5.00; 95% CI 0-7.6). Metoclopramide (n = 57 administrations), dexamethasone (n = 28), eating small servings of food (n = 13), and aloe (n = 11) were the most commonly used rescue therapies.
Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point, and these should be assessed across and beyond the 120-hour period.
化疗引起的恶心、呕吐和干呕（CINVR）仍然是治疗的常见副作用。大多数先前的研究都集中在控制呕吐上；对恶心和干呕的研究较少。本研究旨在描述急性（0-24 小时）、延迟（>24-120 小时）和总体（0-120 小时）化疗后以及 120 小时后（直至下次化疗）CINVR 的发生率、严重程度和对日常生活的影响（IDL）；以及患者采用的药物和非药物策略来缓解症状。
这是一项针对 60 名接受化疗的患者的单中心、横断面研究。参与者从化疗当天开始报告 CINVR 的频率、严重程度和 IDL，直至 120 小时后，以及 120 小时后出现的恶心和呕吐，并报告使用的药物和非药物治疗方法。
47 名（78.3%，95%置信区间[CI] 66.4-86.9）、37 名（61.7%，95% CI 49.0-72.9）和 35 名（58.3%，95% CI 45.7-69.9）患者报告在急性、延迟和总体期间无恶心（数字评分量表 ⩽1）、呕吐或干呕。在整个观察期间，恶心比呕吐和干呕更频繁、更严重且对 IDL 的影响更大；在 120 小时后，有 11 名（18.3%，95% CI 10.6-29.9）患者报告有恶心，而无呕吐，中位数 IDL 为 1/10（四分位距：0.75-5.00；95% CI 0-7.6）。甲氧氯普胺（n = 57 次给药）、地塞米松（n = 28）、少食多餐（n = 13）和芦荟（n = 11）是最常用的解救治疗药物。
未来的研究应将无任何症状等硬性结局作为主要终点，并应在 120 小时内和 120 小时后进行评估。
