Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, Gifu, Japan.
Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Anticancer Res. 2022 Jun;42(6):3117-3123. doi: 10.21873/anticanres.15800.
BACKGROUND/AIM: Nausea and vomiting are two of the most distressing adverse events of cancer radiotherapy. The aim of this study was to examine the control rate and risk factors associated with nausea and vomiting in patients with cervical cancer receiving radiotherapy.
This retrospective study examined patients with cervical cancer who received radiotherapy alone or with concomitant cisplatin. Patients who received radiotherapy alone were not administered antiemetic premedication, while patients who received radiotherapy with concomitant weekly cisplatin (40 mg/m) were administered antiemetic therapy comprising granisetron and dexamethasone. Risk factors for non-complete response (CR) were identified using multivariate logistic regression analysis.
Multivariate analysis indicated that younger age and concomitant weekly cisplatin were significant factors associated with non-CR across 5 weeks of treatment in patients who received radiotherapy. The proportion achieving CR among younger patients (<65 years) who received radiotherapy alone or with concomitant cisplatin was significantly lower than that among older patients (≥65 years) (Concomitant cisplatin: 27% vs. 67%, p=0.049; Radiotherapy alone: 62% vs. 91%, p=0.166). However, the proportion of patients achieving CR across 5 weeks of treatment was insufficient in all groups except for those aged ≥ 65 years who received radiotherapy alone.
Antiemetic prophylaxis should be considered for younger patients with cervical cancer undergoing radiotherapy alone. Further, neurokinin-1 receptor antagonist should be added to 5-hydroxytryptamine type-3 receptor antagonist and dexamethasone as antiemetic prophylactic therapy for patients with cervical cancer undergoing radiotherapy with concomitant weekly doses of 40 mg/m cisplatin.
背景/目的：恶心和呕吐是癌症放射治疗中最令人痛苦的两种不良反应。本研究旨在研究宫颈癌放疗患者恶心和呕吐的控制率及相关危险因素。
本回顾性研究纳入了单独接受放疗或同时接受顺铂治疗的宫颈癌患者。单独接受放疗的患者未给予止吐药预处理，而同时接受每周 40mg/m 顺铂放疗的患者则给予格拉司琼和地塞米松止吐治疗。采用多变量逻辑回归分析确定非完全缓解（CR）的危险因素。
多变量分析表明，年龄较小和同时接受每周顺铂治疗是接受放疗的患者在治疗 5 周时非 CR 的显著相关因素。单独接受放疗或同时接受顺铂治疗的年轻患者（<65 岁）的 CR 比例明显低于老年患者（≥65 岁）（同时接受顺铂：27% vs. 67%，p=0.049；单独接受放疗：62% vs. 91%，p=0.166）。然而，除了单独接受放疗且年龄≥65 岁的患者外，所有组在 5 周治疗期间达到 CR 的患者比例都不足。
对于单独接受放疗的年轻宫颈癌患者，应考虑进行止吐预防。此外，对于接受每周 40mg/m 顺铂放疗的宫颈癌患者，应将神经激肽-1 受体拮抗剂添加到 5-羟色胺 3 受体拮抗剂和地塞米松中作为止吐预防治疗。
