West China Hospital, Sichuan University, Chengdu, China.
The Third People's Hospital of Chengdu, Chengdu, China.
J Cancer Res Clin Oncol. 2021 Sep;147(9):2701-2708. doi: 10.1007/s00432-021-03554-1. Epub 2021 Feb 14.
Nausea and vomiting are the most painful and feared side effects for patients during chemotherapy. Currently, most studies focus on the occurrence of CINV during the risk phase. We initiated this real-world study to understand the actual occurrence of CINV throughout all phases, to provide a basis to prevent CINV in patients during chemotherapy and improve their quality of life.
This prospective real-world study was conducted at 17 major cancer centers in Sichuan, China. Cancer patients who were about to receive moderately/highly emetogenic chemotherapy were included in the study. Occurrences of nausea and vomiting were recorded using patient diaries, and physicians are responsible for recording patient clinical data.
A total of 1,139 patients were included in this study between August 2018 and April 2019. In this study, the incidence of acute CINV was 55.3%, delayed CINV was 62.3%, and CINV beyond the risk period was 36%. All phases overall, the overall complete control (CC) rate of CINV was 30.1 and 32.1% for highly and moderately emetogenic chemotherapy regimens, respectively. The median CC time for CINV was 7 days, but only 21.5% of these patients used antiemetic regimens according to the NCCN guideline.
In the real world, the incidence of CINV is high in patients receiving chemotherapy, and nausea and vomiting may occur beyond the risk period; the low level of standardized antiemetic treatment in compliance with the guideline might have been the main reason for unsatisfactory prevention and control of CINV in this study.
恶心和呕吐是化疗患者最痛苦和最担心的副作用。目前,大多数研究都集中在风险期内 CINV 的发生。我们开展这项真实世界研究是为了了解整个化疗周期中 CINV 的实际发生情况,为化疗患者预防 CINV 提供依据,提高其生活质量。
这是一项在中国四川 17 家主要癌症中心开展的前瞻性真实世界研究。纳入即将接受中高度致吐性化疗的癌症患者。使用患者日记记录恶心和呕吐的发生情况,由医生负责记录患者的临床数据。
2018 年 8 月至 2019 年 4 月期间,共有 1139 例患者入组本研究。本研究中,急性 CINV 的发生率为 55.3%,迟发性 CINV 发生率为 62.3%,风险期后 CINV 发生率为 36%。所有周期总体上,高度和中度致吐性化疗方案的 CINV 完全控制(CC)率分别为 30.1%和 32.1%。CINV 的 CC 中位时间为 7 天,但只有 21.5%的患者根据 NCCN 指南使用了止吐方案。
在真实世界中,接受化疗的患者 CINV 发生率较高,且恶心和呕吐可能发生在风险期之外;不规范的止吐治疗,未遵循指南,可能是本研究中 CINV 预防和控制效果不佳的主要原因。