One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient

Abstract

Objective To describe the prevalence of nausea and vomiting during radiotherapy and to compare quality of life, psychological and functional status in patients experiencing or not experiencing nausea.Materials and methods A cross-sectional selection of 368 cancer patients treated with radiotherapy answered a questionnaire (=93% answering rate) regarding nausea, vomiting, actual use of and interest in antiemetic treatment, quality of life and psychological and functional status during the preceding week of radiotherapy. Mean age was 60 years and 66% were women. Main results Nausea was experienced by 39% (145) and vomiting by 7% (28) of patients in general, by 63% in abdominal or pelvic fields and by 48% in head/neck/brain fields. Abdominal/pelvic field (Relative risk (RR) 2.0), age ≤40 years (RR 1.9) and previous nausea in other situations (RR 1.8) implied an increased risk for nausea. Antiemetics were used by 17% and 78% were interested in or wanted more information about acupuncture treatment against nausea. Of the 145 nauseous patients only 25% felt that antiemetics had helped them and 34% would have liked additional treatment, although the nausea intensity was mild in 72%. The nauseous patients reported lower well-being and quality of life, lower satisfaction with aspects of daily living and more frequent anxiety and depressed mood than the patients without nausea. Conclusions Of all patients undergoing radiotherapy, 39% experienced nausea and one third of them would have liked more treatment against the nausea. This study stresses the importance to identify and adequately treat patients with increased risk for nausea related to radiotherapy.

Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009

“…The incidence and management of RINV have been recently updated in two prospective observational studies [5,29]. The first survey showed that although approximately one third of radiotherapy patients experienced nausea and vomiting, the vast majority (85%) were not prescribed antiemetics [5].…”

“…It was also highlighted that the attitude of radiation oncologists in prescribing antiemetic drugs as a rescue, with a large range of doses and schedules, and that 5-hydroxytryptamine (5-HT 3 ) receptor antagonists rather than other antiemetics were generally being used [42,7,9,14,29]. In 2009, undertreatment of RINV of patients undergoing radiotherapy is still a reality, as shown in two large observational trials [5,29].…”

Patient- and Treatment-Related Risk Factors for Nausea and Emesis during Concurrent Chemoradiotherapy

“…Even in the era of 5-HT 3 antagonists, nausea and vomiting were rated by patients as the most distressing side effects of chemotherapy [8]. For radiotherapy, where these acute reactions are considered to be less frequent and severe, the problem tends to be underestimated: according to a recent survey, one-third of patients with radiotherapy-induced nausea considered their antiemetic treatment insufficient [5].…”

Pilot Testing of Methods for Evaluation of Acupuncture for Emesis during Radiotherapy: A Randomised Single Subject Experimental Design

“…Male gender decreases the emesis risk, while an age below 40 years, previous experience of nausea, and a testicular tumour increases the emesis risk. [11][12][13] We excluded patients with signifi cant nausea before radiotherapy to minimise the threats against the internal validity by avoiding changes in other sources of nausea, for example, vestibular neuritis. In a larger randomised study, confounding factors for nausea would be equally distributed between groups.…”