Factors Modifying the Risk of Acute and Conditioned Nausea and Vomiting in Ovarian-Cancer Patients

Hursti, Timo; Fredrikson, Mats; Fürst, C J; Börjeson, Sussanne; Peterson, Curt; Steineck, Gunnar

doi:10.3892/ijo.4.3.695

Cited by 4 publications

(6 citation statements)

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“…In adult cancer patients, factors associated with a higher risk of chemotherapy‐induced nausea and vomiting in the acute phase are age less than 50 years, 55 years, or 65 years; presence of anticipatory nausea; light alcohol use; female sex; and history of nausea related to pregnancy or other causes . Factors identified as being associated with CIN, separate from chemotherapy‐induced vomiting, in adult cancer patients are duration of the chemotherapy block (two days vs one day), previous distress during blood sampling, and odor memory . Knowledge of these factors has led several groups of investigators to develop algorithms to personalize antiemetic prophylaxis .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for chemotherapy‐induced nausea in pediatric patients receiving highly emetogenic chemotherapy

Dupuis

Tamura

Kelly

et al. 2018

Pediatric Blood & Cancer

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Background Little is known regarding risk factors for chemotherapy‐induced nausea (CIN) in pediatric patients. Procedure A secondary analysis was conducted of a previously published multicenter, prospective, randomized, single‐blind, sham‐controlled trial assessing the efficacy of acupressure in preventing CIN in pediatric patients receiving highly emetogenic chemotherapy. The primary outcome was nausea severity, self‐reported using the Pediatric Nausea Assessment Tool. The relationships between acute and delayed nausea severity and patient‐ (sex, race, age, and cancer diagnosis) and treatment‐related (chemotherapy, antiemetic prophylaxis, CIN, and vomiting control) factors were analyzed by a proportional odds generalized estimating equation approach. The acute phase started with administration of the first and continued for 24 hours after the last chemotherapy dose. The delayed phase started at the end of the acute phase and continued until the next chemotherapy block (maximum seven days). Results In the acute and delayed phases, 165 and 144 patients provided data for analysis, respectively. Nonwhite race was significantly associated with higher acute phase nausea severity (OR, 1.7; 95% CI, 1.1–2.6). Poor CIN control in the acute phase (OR, 16; 95% CI, 4.0–64.6), diagnosis of a cancer other than a central nervous system (CNS) tumor (OR, 2.5; 95% CI, 1.2–5.3), and cisplatin administration (OR, 3.7; 95% CI, 2.1–6.0) were significantly associated with higher delayed phase nausea severity. Conclusion Acute phase CIN was associated with nonwhite race. Delayed phase CIN was associated with poor acute phase CIN control, diagnosis of non‐CNS cancer, and receipt of cisplatin. These findings will inform future antiemetic trial design.

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Section: Discussionmentioning

confidence: 99%

Risk factors for chemotherapy‐induced nausea in pediatric patients receiving highly emetogenic chemotherapy

Dupuis

Tamura

Kelly

et al. 2018

Pediatric Blood & Cancer

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“…Fewer patients in the placebo group than in the dexamethasone group had no acute nausea with a possible selection of patients less prone to experiencing nausea and vomiting. Previous studies have shown that susceptibility to nausea in other situations and also a high level of neuroticism are risk factors for nausea in cancer chemotherapy [11]. The patients without acute nausea in the placebo group had less previous susceptibility to nausea than the patients without acute nausea in the dexamethasone group, especially during the first cycle (P =0.07, Fisher's exact test).…”

Section: Discussionmentioning

confidence: 78%

“…This entails a risk of selecting more nausea-resistant patients in the placebo group and biasing the results. Therefore demographics for candidate risk factors for nausea and vomiting [11] in the whole study groups and in the subsets of patients with no acute nausea in the three cycles are shown in Table 3. Figure 4 shows the urinary cortisol excretion data in the 5 non-naive patients after a single dose of 20 mg dexamethasone in addition to ondansetron.…”

Section: Resultsmentioning

confidence: 99%

“…For the evaluation of the comparability of the study groups, some individual characteristics that could modify the severity of nausea and emesis [11] were assessed before treatment.The patients were asked about their previous susceptibility to nausea and emesis and they completed the State Trait Anxiety Inventory [22], the Eysenck Personality Questionnaire [6], and the Autonomic Perception Questionnaire [3].…”

Section: Evaluation Of Nausea and Emesismentioning

confidence: 99%

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Single high-dose dexamethasone improves the effect of ondansetron on acute chemotherapy-induced nausea and vomiting but impairs the control of delayed symptoms

Peterson

Hursti

Börjeson

et al. 1996

Support Care Cancer

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The introduction of serotonin receptor (5-HT3) antagonists has improved the control of acute nausea and vomiting induced by cancer chemotherapy, but they seem to have little or no effect on delayed symptoms. Corticosteroids are known to reduce both acute and delayed nausea and vomiting. The aim of the present study was to test the hypothesis that a single high dose of dexamethasone (20 mg), a long-acting corticosteroid, given after cisplatin and in addition to ondansetron (8 mg three times a day), would enhance the control of both acute and delayed nausea and vomiting. A group of 104 chemotherapy-naive ovarian cancer patients, scheduled for at least three cycles of combination chemotherapy including cisplatin (50 mg/m2), were randomly allocated to receive either dexamethasone or placebo in addition to ondansetron. Two-thirds of the patients received doxorubin and melphalan on the day before cisplatin and 1/3 received doxorubicin immediately before cisplatin. Unexpectedly we found, in all three chemotherapy cycles, that patients receiving dexamethasone suffered from more delayed nausea and vomiting than patients receiving placebo. In patients with no acute nausea or vomiting, the boomerang effect of dexamethasone could be seen on the first day after chemotherapy. In a follow-up study on 5 patients not included in the randomized trial, dexamethasone induced a pronounced reduction in urinary cortisol excretion on the day after chemotherapy with a return to normal excretion on day 2. It is concluded that a single high dose of dexamethasone does not seem appropriate for controlling delayed nausea and vomiting.

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“…In the light of the suggested mechanisms for delayed Some other characteristics previously reported as associated with chemotherapy-related nausea and vomiting were also assessed (Andrykowski and Gregg, 1992;Hursti et al, 1992Hursti et al, , 1994Martin and Diaz-Rubio, 1990;Morrow, 1985). These were age, history of nausea and vomiting in general and in specific situations (motion sickness, nausea during pregnancy, nausea related to alcohol consumption), trait and state anxiety (Spielberger et al, 1968), neuroticism (Eysenck and Eysenck, 1964) and autonomic perception (Borcovec, 1976).…”

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confidence: 99%

Impact of tumour burden on chemotherapy-induced nausea and vomiting

Hursti

Åvall‐Lundqvist²,

Börjeson³

et al. 1996

Br J Cancer

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Summary We investigated how residual tumour burden after cytoreductive surgery was related to the occurrence of acute and delayed nausea and vomiting in 101 ovarian cancer patients receiving their first chemotherapy course. The anti-emetic treatment included ondansetron combined with dexamethasone or placebo. After chemotherapy all patients received ondansetron only for 5 days. Two categories of tumour burden (TB) were formed according to the diameter of the greatest residual tumour (<2 cm = minimal TB and > 2 cm= large TB). Self-reports of nausea and vomiting were obtained for 15 days. Other potential predictor variables were assessed and included in multivariate analyses. Patients with large compared with minimal TB had more delayed emesis, especially on days 2-7. They also had more acute nausea. The aggravating effect associated with large residual TB was more evident in patients >55 years. During the second week after the chemotherapy the occurrence of nausea was higher in patients >55 years than in those <55 years. This was seen primarily in patients with large residual TB. Predictors for no delayed emesis at all were anti-emetic treatment with dexamethasone, minimal tumour burden, low neuroticism and no history of motion sickness. The increased risk of 'persistent' delayed nausea and vomiting seen in older patients with large tumour burden may have important clinical implications and warrants further attention.

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Factors Modifying the Risk of Acute and Conditioned Nausea and Vomiting in Ovarian-Cancer Patients

Cited by 4 publications

References 0 publications

Risk factors for chemotherapy‐induced nausea in pediatric patients receiving highly emetogenic chemotherapy

Risk factors for chemotherapy‐induced nausea in pediatric patients receiving highly emetogenic chemotherapy

Single high-dose dexamethasone improves the effect of ondansetron on acute chemotherapy-induced nausea and vomiting but impairs the control of delayed symptoms

Impact of tumour burden on chemotherapy-induced nausea and vomiting

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