Renown Institute for Cancer, Reno, NV, USA.
World Health Organization, Atlanta, GA, USA.
Support Care Cancer. 2023 Oct 25;31(12):654. doi: 10.1007/s00520-023-08119-1.
Chemotherapy-induced nausea and vomiting (CINV)'s impact on work loss remains poorly described. We evaluated associations between the duration of CINV episodes, CINV-related work loss (CINV-WL), and CINV-related activity impairment (CINV-AI) in patients with breast cancer receiving highly emetogenic chemotherapy.
We analyzed data from a prospective CINV prophylaxis trial of netupitant/palonestron and dexamethasone for patients receiving an anthracycline and cyclophosphamide (AC) for breast cancer (NCT0340371). Over the observed CINV duration (0-5 days), we analyzed patient-reported CINV-WL and CINV-AI for the first two chemotherapy cycles. We categorized patients as having either extended (≥ 3 days) or short (1-2 days) CINV duration and quantified its impact on work using the Work Productivity and Activity Impairment Questionnaire (WPAI).
Overall, we captured data for 792 cycles in 402 women, including 136 (33.8%) employed patients with 35.3% reporting CINV. Of those with CINV, patients reported CINV-WL in 26 cycles and CINV-AI in 142 cycles. Of those with CINV, 55.3% of extended CINV cycles experienced CINV-WL compared to 16.7% of short CINV cycles (p < 0.001). The relative risk of CINV-WL between extended and short CINV was 3.32 (p < 0.01) for employed patients. The mean difference in CINV-AI scores (higher = worse) between extended and short duration CINV was 5.0 vs. 3.0 (p < 0.001).
Extended (≥ 3 days) CINV was associated with more than triple the risk of CINV-WL and higher CINV-AI compared with short CINV.
化疗引起的恶心和呕吐（CINV）对工作损失的影响描述得还不够充分。我们评估了接受高致吐性化疗的乳腺癌患者中 CINV 发作持续时间、CINV 相关工作损失（CINV-WL）和 CINV 相关活动障碍（CINV-AI）之间的关联。
我们分析了一项接受蒽环类药物和环磷酰胺（AC）化疗的乳腺癌患者接受奈妥吡坦/帕洛诺司琼和地塞米松预防 CINV 的前瞻性 CINV 预防试验的数据（NCT0340371）。在观察到的 CINV 持续时间（0-5 天）内，我们分析了前两个化疗周期中患者报告的 CINV-WL 和 CINV-AI。我们将患者分为 CINV 持续时间较长（≥3 天）或较短（1-2 天），并使用工作生产力和活动障碍问卷（WPAI）量化其对工作的影响。
总体而言，我们共纳入了 402 名女性的 792 个周期的数据，其中 136 名（33.8%）患者为在职人员，其中 35.3%报告有 CINV。在有 CINV 的患者中，有 26 个周期报告有 CINV-WL，142 个周期报告有 CINV-AI。在有 CINV 的患者中，55.3%的长 CINV 周期经历了 CINV-WL，而 16.7%的短 CINV 周期经历了 CINV-WL（p<0.001）。在职患者中，长 CINV 和短 CINV 之间 CINV-WL 的相对风险为 3.32（p<0.01）。长 CINV 和短 CINV 之间 CINV-AI 评分的平均差异（更高表示更差）为 5.0 分与 3.0 分（p<0.001）。
与短 CINV 相比，长（≥3 天）CINV 与 CINV-WL 的风险增加三倍以上，并且 CINV-AI 更高。
