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Chemotherapy-induced nausea and vomiting in routine practice: a European perspective

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Abstract

Goals of work

The aim of this study was to evaluate the occurrence of chemotherapy-induced nausea and vomiting (CINV) and its effect on patients’ ability to carry out daily life activities following moderately to highly emetogenic, first-cycle chemotherapy in routine practice in cancer centers of four different European countries.

Patients and methods

This was a prospective, cross-sectional, nonrandomized, self-assessment study in 249 patients enrolled from cancer centers in Spain, Austria, Germany, and Switzerland. The study population consisted of 78% women, with a mean age of 54. Breast, lung, and ovarian cancers made up 75% of all cancers in the study. Patients received a mean of 2.0 chemotherapy agents and 2.5 antiemetic drugs.

Main results

A total of 450 emetic episodes experienced by 243 patients was recorded over 5 days following chemotherapy, with an average of 1.8 episodes per patient (range: 0–28). A higher percentage of patients (38%) suffered from delayed compared to acute emesis (13%). Between 42% and 52% of all patients suffered from nausea (visual analogue scale ≥5 mm) on any one day, peaking at day 3. Using the Functional Living Index for Emesis (FLIE) questionnaire, 75% of patients with nausea and 50% with vomiting reported a negative impact of these conditions on performance of daily living.

Conclusions

CINV remains a significant problem in routine practice, particularly in the delayed phase posttreatment. Overall, CINV had a negative impact on patients’ daily life.

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References

  1. Antiemetic Subcommittee of the Multinational Association of Supportive Care in Cancer (MASCC) (1998) Prevention of chemotherapy- and radiotherapy-induced emesis: results of the Perugia Consensus Conference. Ann Oncol 9:811–819

    Article  PubMed  Google Scholar 

  2. Aapro MS (2002) How do we manage patients with refractory or breakthrough emesis? Support Care Cancer 10:106–109

    Article  PubMed  Google Scholar 

  3. ASHP (1999) Therapeutic Guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery. Am J Health Syst Pharm 56:729–764

    PubMed  Google Scholar 

  4. Barrenetxea G, Schneider J, Centeno MM, et al (1996) Chemotherapy-induced emesis: management of early and delayed emesis in milder emetogenic regimens. Cancer Chemother Pharmacol 38:471–475

    Article  CAS  Google Scholar 

  5. Bender CM, McDaniel RW, Murphy-Ende K, et al (2002) Chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs 6:94–102

    PubMed  Google Scholar 

  6. Bliss JM, Robertson B, Selby PJ (1992) The effect of nausea and vomiting upon quality of life measures. Brit J Cancer 66:14S–23S

    Google Scholar 

  7. Borjeson S, Hursti TJ, Peterson C, et al (1997) Similarities and differences in assessing nausea and vomiting on a verbal category scale and a visual analogue scale. Cancer Nurs 20:260–266

    Article  CAS  PubMed  Google Scholar 

  8. Cocquyt V, Van Belle S, Reinhardt RR, et al (2001) Comparison of L-758,298, a prodrug for the selective neurokinin-1 antagonist, L-754–030, with ondansetron for the prevention of cisplatin-induced emesis. Eur J Cancer 37:835–842

    Article  CAS  PubMed  Google Scholar 

  9. Cubeddu LX (1996) Serotonin mechanisms in chemotherapy-induced emesis in cancer patients. Oncology 53 [Suppl 1]:18–25

    Google Scholar 

  10. du Bois A, Kriesinger-Schroeder H, Meerpohl HG (1995) The role of serotonin as a mediator of emesis induced by different stimuli. Support Care Cancer 3:285–290

    PubMed  Google Scholar 

  11. Farley PA, Dempsey CL, Shillington AA, et al (1997) Patients’ self-reported functional status after granisetron or ondansetron therapy to prevent chemotherapy-induced nausea and vomiting at six cancer centers. Am J Health Syst Pharm 54:2478–2482

    CAS  PubMed  Google Scholar 

  12. Gralla RJ, Osoba D, Kris MG, et al (1999) Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines. American Society of Clinical Oncology. J Clin Oncol 17:2971–2994

    CAS  PubMed  Google Scholar 

  13. Gregory RE, Ettinger DS (1998) 5-HT3 receptor antagonists for the prevention of chemotherapy-induced nausea and vomiting. A comparison of their pharmacology and clinical efficacy. Drugs 55:173–189

    CAS  PubMed  Google Scholar 

  14. Griffin AM, Butow PN, Coates AS, et al (1996) On the receiving end. V: Patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7:189–195

    CAS  PubMed  Google Scholar 

  15. Grunberg SM, Osoba D, Hesketh PJ, et al (2004) Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity—an update. Support Care Cancer (in press)

  16. Havsteen H, Kjaer M (1991) Double-blind randomized cross-over trial comparing methylprednisolone with placebo in chemotherapy-induced nausea and vomiting: a study with special reference to efficacy parameters. Anticancer Drugs 2:571–579

    CAS  PubMed  Google Scholar 

  17. Hollander M, Wolfe DA (1998) Nonparametric Statistical Methods. Wiley, New York

  18. Homesley HD, Gainey JM, Jobson VW, et al (1982) Cisplatin chemotherapy and emesis in patients given metoclopramide and controls. N Engl J Med 307:250

    Google Scholar 

  19. Koeller JM, Aapro MS, Gralla RJ, et al (2002) Antiemetic guidelines: creating a more practical treatment approach. Support Care Cancer 10:519–522

    Article  PubMed  Google Scholar 

  20. Kris MG, Gralla RJ, Clark RA, et al (1985) Incidence, course, and severity of delayed nausea and vomiting following the administration of cisplatin. J Clin Oncol 3:1379–1384

    CAS  PubMed  Google Scholar 

  21. Kris MG, Pisters KM, Hinkley L (1994) Delayed emesis following anticancer chemotherapy. Support Care Cancer 2:297–300

    CAS  PubMed  Google Scholar 

  22. Kris MG, Radford J, Pizzo BA, et al (1997) Use of an NK1 receptor antagonist to prevent delayed emesis after cisplatin. J Natl Cancer Inst 89:817–818

    Article  CAS  PubMed  Google Scholar 

  23. Lindley CM, Hirsch JD (1992) Nausea and vomiting and cancer patients’ quality of life: a discussion of Professor Selby’s paper. Br J Cancer Suppl 19:S26–S29

    CAS  PubMed  Google Scholar 

  24. Lindley CM, Hirsch JD, O’Neill CV, et al (1992) Quality of life consequences of chemotherapy-induced emesis. Qual Life Res 1:331–340

    CAS  PubMed  Google Scholar 

  25. Markman M (2002) Progress in preventing chemotherapy-induced nausea and vomiting. Cleve Clin J Med 69:609–610, 612, 615–617

    PubMed  Google Scholar 

  26. Martin AR, Cai B, Pearson J, et al (2001) Patient-assessed impact of chemotherapy-induced nausea on daily life: how much is too much? Oncol Nurs For 28:338

    Google Scholar 

  27. McCune JS, Oertel MD, Pfeifer D, et al (2001) Evaluation of outcomes in converting from intravenous ondansetron to oral granisetron: an observational study. Ann Pharmacoth 35:14–20

    Article  CAS  Google Scholar 

  28. Morrow GR, Hickok JT, Burish TG, et al (1996) Frequency and clinical implications of delayed nausea and delayed emesis. Am J Clin Oncol 19:199–203

    Article  CAS  PubMed  Google Scholar 

  29. Muth ER, Stern RM, Thayer JF, et al (1996) Assessment of the multiple dimensions of nausea: the Nausea Profile (NP). J Psychosom Res 40:511–520

    Article  CAS  PubMed  Google Scholar 

  30. Navari RM, Reinhardt RR, Gralla RJ, et al (1999) Reduction of cisplatin-induced emesis by a selective neurokinin-1-receptor-antagonist. L-754,030. Antiemetic Trials Group. N Engl J Med 340:190–195

    Article  CAS  PubMed  Google Scholar 

  31. NCCN antiemesis practice guidelines (1997) Oncology 11:57–89

    PubMed  Google Scholar 

  32. Osoba D, Zee B, Warr D, et al (1997) Effect of postchemotherapy nausea and vomiting on health-related quality of life. The Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group. Support Care Cancer 5:307–313

    Article  CAS  PubMed  Google Scholar 

  33. Ossi M, Anderson E, Freeman A (1996) 5-HT3 receptor antagonists in the control of cisplatin-induced delayed emesis. Oncology 53 suppl 1:78–85

    Google Scholar 

  34. Rizk AN, Hesketh PJ (1999) Antiemetics for cancer chemotherapy-induced nausea and vomiting. A review of agents in development. Drugs R D 2:229–235

    CAS  PubMed  Google Scholar 

  35. Roila F, Donati D, Tamberi S, Margutti G (2002) Delayed emesis: incidence, pattern, prognostic factors and optimal treatment. Support Care Cancer 10:88–95

    Article  PubMed  Google Scholar 

  36. Roscoe JA, Hickok JT, Morrow GR (2000) Patient expectations as predictor of chemotherapy-induced nausea. Ann Behav Med 22:121–126

    CAS  PubMed  Google Scholar 

  37. Roscoe JA, Morrow GR, Hickok JT, et al (2000) Nausea and vomiting remain a significant clinical problem: trends over time in controlling chemotherapy-induced nausea and vomiting in 1413 patients treated in community clinical practices. J Pain Symptom Manage 20:113–21

    Article  CAS  PubMed  Google Scholar 

  38. Uyl-de Groot CA, Wait S, Buijt I (2000) Economics and health-related quality of life in antiemetic therapy: recommendations for trial design. Eur J Cancer 36:522–535

    Google Scholar 

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Acknowledgements

This study represents a project of the European Oncology Nursing Society and was supported by an unrestricted project grant from Merck & Co., Inc., USA. We thank all patients who were willing to assist in this study whilst going through a difficult time. We also thank the board members of the European Oncology Nursing Society for the support of this project. We acknowledge the medical writers Ms. Helena Corte-Real and Mr. Charles Robinson, Phocus, Basel, Switzerland. We thank Dr. Steven Grunberg, Fletcher Allen Health Care, University of Vermont, USA, for his critical review of the manuscript.

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Authors and Affiliations

  1. Zentrum für Tumordiagnostik und Prävention (ZeTuP), Rorschacher Strasse 150, 9006 St. , Gallen, Switzerland

    Agnes Glaus, Cornelia Knipping & Rudolf Morant

  2. Department of Innere Medizin, Kantonsspital St. Gallen (KSSG), 9007, St. Gallen, Switzerland

    Christel Böhme

  3. Universitätsklinikum Heidelberg Fachweiterbildung, Im Neuenheimer Feld 105, 69120, Heidelberg, Germany

    Burkhard Lebert & Frank Beldermann

  4. LKH-Universitätsklinikum, Medizinische Universitätsklinik, Auenbruggerplatz 15, 8036, Graz, Austria

    Bernhard Glawogger

  5. Institut Catala Oncologia ICO, Av. Castelldefels s/n/km 2, 7 l’Hospitalet., 08907 , Barcelona, Spain

    Paz Fernandez Ortega

  6. Institut für mathematische Statistik und Versicherungslehre, Universität Bern, Sidlerstrasse 5, 3012, Bern, Switzerland

    André Hüsler

  7. Merck & Co., Inc., One Merck Drive, PO Box 100 (WS2E-76), Whitehouse Station, NJ 08889, USA

    Robert Deuson

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  1. Agnes Glaus
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  2. Cornelia Knipping
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  3. Rudolf Morant
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Corresponding author

Correspondence to Agnes Glaus.

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Glaus, A., Knipping, C., Morant, R. et al. Chemotherapy-induced nausea and vomiting in routine practice: a European perspective. Support Care Cancer 12, 708–715 (2004). https://doi.org/10.1007/s00520-004-0662-x

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  • DOI: https://doi.org/10.1007/s00520-004-0662-x

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