Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.
Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
Radiol Med. 2024 Mar;129(3):457-466. doi: 10.1007/s11547-024-01757-3. Epub 2024 Feb 14.
Cisplatin-based chemoradiotherapy (CRT) is standard treatment for head and neck squamous cell carcinoma (HNSCC). However, IMRT may increase chemotherapy-induced nausea and vomiting (CINV). The purpose of this study is to investigate the effect of fosaprepitant in preventing CINV.
An infusion of 150 mg fosaprepitant was given through a 30 min. We assessed acute toxicity using CTCAE v.4 and the incidence of CINV using the FLIE questionnaire. The evaluation of CINV was done at the second and fifth weeks of CRT and 1 week after the end. The EORTC QLQ-HN 43 questionnaire was administered before treatment beginning (baseline), at second (T1) and fifth (T2) weeks. A dosimetric analysis was performed on dorsal nucleus of vagus (DVC) and area postrema (AP).
Between March and November 2020, 24 patients were enrolled. No correlation was found between nausea and DVC mean dose (p = 0.573), and AP mean dose (p = 0.869). Based on the FLIE questionnaire, patients reported a mean score of 30.5 for nausea and 30 for vomiting during week 2 and 29.8 for nausea and 29.2 for vomiting during week 5. After treatment ended, the mean scores were 27.4 for nausea and 27.7 for vomiting. All patients completed the EORTC QLQ-HN 43. Significantly higher scores at T2 assessment than baseline were observed.
The use of fosaprepitant in preventing CINV reduced incidence of moderate to severe nausea and vomiting. No correlation has been found between nausea and median dose to DVC and AP.
顺铂为基础的放化疗（CRT）是头颈部鳞状细胞癌（HNSCC）的标准治疗方法。然而，调强放疗（IMRT）可能会增加化疗引起的恶心和呕吐（CINV）。本研究旨在探讨福沙匹坦预防 CINV 的效果。
通过 30 分钟输注 150mg 福沙匹坦。我们使用 CTCAE v.4 评估急性毒性，使用 FLIE 问卷评估 CINV 的发生率。在 CRT 的第二和第五周以及 CRT 结束后一周评估 CINV。在治疗开始前（基线）、第二周（T1）和第五周（T2）进行 EORTC QLQ-HN 43 问卷评估。对迷走神经背核（DVC）和后极（AP）进行剂量分析。
2020 年 3 月至 11 月期间，共纳入 24 例患者。恶心与 DVC 平均剂量（p=0.573）和 AP 平均剂量（p=0.869）之间无相关性。根据 FLIE 问卷，患者在第 2 周和第 5 周报告的恶心平均评分为 30.5，呕吐平均评分为 30，第 2 周和第 5 周报告的恶心平均评分为 29.8，呕吐平均评分为 29.2，治疗结束后，恶心和呕吐的平均评分分别为 27.4 和 27.7。所有患者均完成了 EORTC QLQ-HN 43。在 T2 评估中，与基线相比，评分显著升高。
福沙匹坦用于预防 CINV 可降低中重度恶心和呕吐的发生率。恶心与 DVC 和 AP 的中位剂量之间无相关性。
