Status Survey on Chemotherapy-Induced Nausea and Vomiting_Chinese Journal of Evidence-Based Medicine

Authors：

DONG Shuang ,  YU Shiying

Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China;

Corresponding author：

YU Shiying, Email: syyu@tjh.tjmu.edu.cn

Keywords：

Chemotherapy-induced nausea and vomiting (CINV); Moderately emetogenic chemotherapy (MEC); Highly emetogenic chemotherapy (HEC); Functional living index-emesis (FLIE); Survey

DOI：

10.7507/1672-2531.20130122

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To investigate the patient’s psychological anticipation and occurrence of chemotherapy-induced nausea and vomiting (CINV), and to assess the influence of CINV on quality of life, so as to provide evidence for clinical doctors to recognize and pay attention to CINV.
Methods 　The patients in the Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology who took either moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC) were randomly sampled with a questionnaire for two circles. Patients were asked to record the following indexes before chemotherapy, on the second day and the sixth day of chemotherapy: acute and delayed nausea and vomiting, independently taking antiemetics, and functional living index-emesis (FLIE). Then, descriptive analysis and multiple linear regression analysis were adopted for the outcomes of investigation.
Results 　A total of 344 patients were investigated, of which 303 fulfilled the questionnaire finally. For the single-day chemotherapy, the acute nausea and vomiting, delayed nausea vomiting and overall complete remission in the MEC group were 86.1%, 76.6%, and 71.5%, respectively; while those of the HEC group were 84.1%, 71.0%, and 66.7%, respectively. For the multi-day chemotherapy, the acute nausea and vomiting, delayed nausea vomiting and overall complete remission were 93.8%, 64.9%, and 64.9%, respectively. Patients’ expectation of nausea and anticipatory anxiety was closely related to the delayed nausea in their prior circle of chemotherapy. Based on the FLIE assessment, about 30% of all patients reported reduced daily living function.
Conclusion 　CINV remains a significant problem among patients in China, especially in controlling the reaction during delayed phase and nausea as well. It requires that more attention should be paid to CINV and more effective prophylaxis should be adopted in clinical practice.

Citation： DONG Shuang,YU Shiying. Status Survey on Chemotherapy-Induced Nausea and Vomiting. Chinese Journal of Evidence-Based Medicine, 2013, 13(6): 687-691. doi: 10.7507/1672-2531.20130122 Copy

1.	Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med, 2008, 358(23): 2482-2494.
2.	Mitchell EP. Gastrointestinal toxicity of chemotherapeutic agents. Semin Oncol, 1992, 19(5): 566-579.
3.	Osoba D, Zee B, Warr D, et al. Effect of postchemotherapy nausea and vomiting on health-related quality of life. Supportive care in cancer, 1997, 5(4): 307-313.
4.	Cohen L, de Moor CA, Eisenberg P, et al. Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support Care Cancer, 2007, 15(5): 497-503.
5.	Wood JM, Chapman K, Eilers J. Tools for assessing nausea, vomiting, and retching. Cancer Nurs, 2011, 34(1): E14-24.
6.	Molassiotis A, Coventry PA, Stricker CT, et al. Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemesis tool. J Pain Symptom Manage, 2007, 34(2): 148-159.
7.	Martin AR, Pearson JD, Cai B, et al. Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ daily lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5-day recall. Support Care Cancer, 2003, 11(8): 522-527.
8.	Smith AR, Repka TL, Weigel BJ. Aprepitant for the control of chemotherapy induced nausea and vomiting in adolescents. Pediatr Blood Cancer, 2005, 45(6): 857-860.
9.	Hesketh PJ, Grunberg SM, Gralla RJ, et al. The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin--the Aprepitant Protocol 052 Study Group. J Clin Oncol, 2003, 21(22): 4112-4119.
10.	Jin Y, Sun W, Gu D, et al. Comparative efficacy and safety of palonosetron with the first 5-HT3 receptor antagonists for the chemotherapy-induced nausea and vomiting: a meta-analysis. Eur J Cancer Care (Engl), 2013, 22(1): 41-50.
11.	Lin SJ, Hatoum HT, Buchner D, et al. Impact of 5-HT3 receptor antagonists on chemotherapy-induced nausea and vomiting: a retrospective cohort study. BMC Health Serv Res, 2012, 12(1): 215.
12.	Navari RM. Pharmacological management of chemotherapy-induced nausea and vomiting: focus on recent developments. Drugs, 2009, 69(5): 515-533.
13.	Bloechl-Daum B, Deuson RR, Mavros P, et al. Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol, 2006, 24(27): 4472-4478.
14.	NCCN Clinical Practice Guidelines in Oncology version 1, 2013. Antiemesis.National Comprehensive Cancer Network (NCCN) [online]. Available from URL: http://www.nccn.org/professionals/physician_gls/PDF/ antiemesis.pdf, 2013).
15.	Shi J, Wei PK. Professor Wei Pin-kang’s experience in treating chemotherapy induced nausea and vomiting: an analysis of herbal medication. China Journal of Integrated Traditional Medicine and Western Medicine, 2012, 32(4): 556-559, 571.
16.	Pillai AK, Sharma KK, Gupta YK, et al. Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy. Pediatr Blood Cancer, 2011, 56(2): 234-238.
17.	Qian QH, Yue W, Wang YX, et al. Gingerol inhibits cisplatin-induced vomiting by down regulating 5-hydroxytryptamine, dopamine and substance P expression in minks. Arch Pharm Res, 2009, 32(4): 565-573.
18.	Grunberg S. Patient-centered management of chemotherapy-induced nausea and vomiting. Cancer Control, 2012, 19(2 Suppl): 10-15.
19.	Richardson J, Smith JE, McCall G, et al. Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review of the research evidence. Eur J Cancer Care (Engl), 2007, 16(5): 402-412.
20.	朱丹, 吕黄伟, 李晓倩, 等. P6 刺激对术后恶心呕吐有效性的 Meta 分析. 中国循证医学杂志, 2010, 10(8): 923-931.
21.	Parfitt A. Acupuncture as an antiemetic treatment. J Altern Complement Med, 1996, 2(1): 167-174; discussion 175-167.
22.	Thompson N. Optimizing treatment outcomes in patients at risk for chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs, 2012, 16(3): 309-313.
23.	So WK, Chan DN, Chan HY, et al. Knowledge and practice among Hong Kong oncology nurses in the management of chemotherapy-induced nausea and vomiting. Eur J Oncol Nurs, 2012.
24.	Salsman JM, Grunberg SM, Beaumont JL, et al. Communicating about chemotherapy-induced nausea and vomiting: a comparison of patient and provider perspectives. J Natl Compr Canc Netw, 2012, 10(2): 149-157.
25.	Radbruch L, Payne S, de Lima L, et al. The Lisbon Challenge: Acknowledging Palliative Care as a Human Right. J Palliat Med, 2013.

1. Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med, 2008, 358(23): 2482-2494.
2. Mitchell EP. Gastrointestinal toxicity of chemotherapeutic agents. Semin Oncol, 1992, 19(5): 566-579.
3. Osoba D, Zee B, Warr D, et al. Effect of postchemotherapy nausea and vomiting on health-related quality of life. Supportive care in cancer, 1997, 5(4): 307-313.
4. Cohen L, de Moor CA, Eisenberg P, et al. Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support Care Cancer, 2007, 15(5): 497-503.
5. Wood JM, Chapman K, Eilers J. Tools for assessing nausea, vomiting, and retching. Cancer Nurs, 2011, 34(1): E14-24.
6. Molassiotis A, Coventry PA, Stricker CT, et al. Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemesis tool. J Pain Symptom Manage, 2007, 34(2): 148-159.
7. Martin AR, Pearson JD, Cai B, et al. Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ daily lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5-day recall. Support Care Cancer, 2003, 11(8): 522-527.
8. Smith AR, Repka TL, Weigel BJ. Aprepitant for the control of chemotherapy induced nausea and vomiting in adolescents. Pediatr Blood Cancer, 2005, 45(6): 857-860.
9. Hesketh PJ, Grunberg SM, Gralla RJ, et al. The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin--the Aprepitant Protocol 052 Study Group. J Clin Oncol, 2003, 21(22): 4112-4119.
10. Jin Y, Sun W, Gu D, et al. Comparative efficacy and safety of palonosetron with the first 5-HT3 receptor antagonists for the chemotherapy-induced nausea and vomiting: a meta-analysis. Eur J Cancer Care (Engl), 2013, 22(1): 41-50.
11. Lin SJ, Hatoum HT, Buchner D, et al. Impact of 5-HT3 receptor antagonists on chemotherapy-induced nausea and vomiting: a retrospective cohort study. BMC Health Serv Res, 2012, 12(1): 215.
12. Navari RM. Pharmacological management of chemotherapy-induced nausea and vomiting: focus on recent developments. Drugs, 2009, 69(5): 515-533.
13. Bloechl-Daum B, Deuson RR, Mavros P, et al. Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol, 2006, 24(27): 4472-4478.
14. NCCN Clinical Practice Guidelines in Oncology version 1, 2013. Antiemesis.National Comprehensive Cancer Network (NCCN) [online]. Available from URL: http://www.nccn.org/professionals/physician_gls/PDF/ antiemesis.pdf, 2013).
15. Shi J, Wei PK. Professor Wei Pin-kang’s experience in treating chemotherapy induced nausea and vomiting: an analysis of herbal medication. China Journal of Integrated Traditional Medicine and Western Medicine, 2012, 32(4): 556-559, 571.
16. Pillai AK, Sharma KK, Gupta YK, et al. Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy. Pediatr Blood Cancer, 2011, 56(2): 234-238.
17. Qian QH, Yue W, Wang YX, et al. Gingerol inhibits cisplatin-induced vomiting by down regulating 5-hydroxytryptamine, dopamine and substance P expression in minks. Arch Pharm Res, 2009, 32(4): 565-573.
18. Grunberg S. Patient-centered management of chemotherapy-induced nausea and vomiting. Cancer Control, 2012, 19(2 Suppl): 10-15.
19. Richardson J, Smith JE, McCall G, et al. Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review of the research evidence. Eur J Cancer Care (Engl), 2007, 16(5): 402-412.
20. 朱丹, 吕黄伟, 李晓倩, 等. P6 刺激对术后恶心呕吐有效性的 Meta 分析. 中国循证医学杂志, 2010, 10(8): 923-931.
21. Parfitt A. Acupuncture as an antiemetic treatment. J Altern Complement Med, 1996, 2(1): 167-174; discussion 175-167.
22. Thompson N. Optimizing treatment outcomes in patients at risk for chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs, 2012, 16(3): 309-313.
23. So WK, Chan DN, Chan HY, et al. Knowledge and practice among Hong Kong oncology nurses in the management of chemotherapy-induced nausea and vomiting. Eur J Oncol Nurs, 2012.
24. Salsman JM, Grunberg SM, Beaumont JL, et al. Communicating about chemotherapy-induced nausea and vomiting: a comparison of patient and provider perspectives. J Natl Compr Canc Netw, 2012, 10(2): 149-157.
25. Radbruch L, Payne S, de Lima L, et al. The Lisbon Challenge: Acknowledging Palliative Care as a Human Right. J Palliat Med, 2013.

Chinese Journal of Evidence-Based Medicine

Status Survey on Chemotherapy-Induced Nausea and Vomiting

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