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多种胃肠道症状与乳腺癌患者化疗所致恶心相关。

Multiple Gastrointestinal Symptoms Are Associated With Chemotherapy-Induced Nausea in Patients With Breast Cancer.

机构信息

Author Affiliations: Edson College of Nursing and Health Innovation, Arizona State University, Phoenix (Drs Singh and Brewer); School of Nursing (Drs Kober, Paul, Cooper, and Miaskowski) and School of Medicine (Drs Melisko, Levine, and Miaskowski), University of California, San Francisco; Mayo Clinic Cancer Center, Phoenix, Arizona (Dr Ernst); HonorHealth Medical Group, Scottsdale, Arizona (Drs Sachdev and Brewer); Biodesign Center for Fundamental and Applied Microbiomics, Arizona State University, Tempe (Dr Zhu); College of Health Solutions, Arizona State University, Phoenix (Dr Gu); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); and School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley).

出版信息

Cancer Nurs. 2022;45(3):181-189. doi: 10.1097/NCC.0000000000000976.

Abstract

BACKGROUND

Unrelieved chemotherapy-induced nausea (CIN) is a significant problem for patients with breast cancer (BC).

OBJECTIVE

In a sample of patients with BC who were assessed before their second or third cycle of chemotherapy, study purposes were to evaluate for the occurrence, severity, frequency, and distress associated with CIN; evaluate for differences in demographic and clinical characteristics and gastrointestinal (GI) symptom occurrence rates between patients who did and did not report CIN; and determine which demographic, clinical, and symptom characteristics were associated with the occurrence of CIN.

METHODS

Patients completed demographic and clinical questionnaires and the Memorial Symptom Assessment Scale for nausea and common GI symptom assessments. Univariate analyses evaluated for differences in demographic and clinical characteristics and GI symptom occurrence between patients who did and did not report CIN. Multiple logistic regression analysis evaluated for characteristics associated with CIN.

RESULTS

Of the 532 patients with BC, 47.2% reported CIN occurrence. Characteristics associated with CIN group membership were poorer functional status, receipt of chemotherapy on a 14-day cycle, and higher occurrence rates of 5 GI symptoms (ie, dry mouth, vomiting, constipation, change in the way food tastes, and lack of appetite; all P < .001).

CONCLUSIONS

Unrelieved CIN is a common symptom in patients with BC. This study is the first to demonstrate that 5 co-occurring GI symptoms were associated with CIN occurrence.

IMPLICATIONS FOR PRACTICE

This study identified new risk factors for CIN occurrence in patients with BC. Clinicians may be able to initiate additional interventions to alleviate CIN.

摘要

背景

乳腺癌(BC)患者化疗引起的恶心(CIN)未得到缓解是一个严重的问题。

目的

在接受第二次或第三次化疗前评估的 BC 患者中,本研究旨在评估 CIN 的发生、严重程度、频率和相关痛苦;评估报告 CIN 与未报告 CIN 的患者在人口统计学和临床特征以及胃肠道(GI)症状发生率方面的差异;并确定哪些人口统计学、临床和症状特征与 CIN 的发生相关。

方法

患者完成人口统计学和临床问卷以及纪念恶心和常见 GI 症状评估量表。单变量分析评估报告 CIN 与未报告 CIN 的患者在人口统计学和临床特征以及 GI 症状发生率方面的差异。多元逻辑回归分析评估与 CIN 相关的特征。

结果

在 532 名 BC 患者中,47.2%报告了 CIN 的发生。与 CIN 组相关的特征是功能状态较差、接受 14 天周期的化疗以及 5 种 GI 症状(即口干、呕吐、便秘、食物味道改变和食欲不振)的发生率较高(均 P<0.001)。

结论

未缓解的 CIN 是 BC 患者的常见症状。本研究首次表明,5 种同时发生的 GI 症状与 CIN 的发生相关。

实践意义

本研究确定了 BC 患者 CIN 发生的新危险因素。临床医生可能能够采取额外的干预措施来缓解 CIN。

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