Prophylactic Tropisetron versus Rescue Tropisetron in Fractionated Radiotherapy to Moderate or High Emetogenic Areas: A Prospective Randomized Open Label Study in Cancer Patients

Mystakidou, Kyriaki; Katsouda, Emmanuela; Λίνου, Α.; Parpa, Efi; Kouloulias, Vassilis; Nikolaou, Vassiliki; Vlahos, Lambros

doi:10.1385/mo:23:2:251

Cited by 13 publications

(10 citation statements)

References 11 publications

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“…Maranzano et al [31] divided the emetic risk into four levels; high risk (>90%) in total body irradiation, moderate risk (60-90%) in upper abdomen, low risk (30-59%) in lower thoracic and pelvic region and minimal risk (<30%) in cranium, breast, extremities and head and neck field. Our study, as well as those from IGARR [25] and Mystakidou et al [36] may suggest that the thoracic and pelvic fields should be classified as producing moderate risk instead of low risk and head, neck or brain field should be classified as low risk instead of minimal risk for nausea.…”

Section: Discussionsupporting

confidence: 74%

“…A combined treatment with a 5-HT 3 antagonist and corticosteroids given as prophylaxis had additional effects compared to a 5-HT 3 antagonist combined with placebo (77% versus 88% experienced nausea or vomiting) [37]. 5HT 3 -receptor antagonists given prophylactic (50% had nausea) was more effective than 5HT 3 -receptor antagonists rescue (65% had nausea) [36]. There are differences between the antiemetic guidelines regarding when and how 5-HT 3 antagonists should be prescribed.…”

Section: Discussionmentioning

confidence: 99%

“…Other previous findings on the prevalence of radiotherapy-induced nausea are based on studies evaluating the effect of antiemetics. Mystakidou et al [36] included 288 radiotherapy patients and found that nausea was experienced by 58% of 50 patients irradiated over the abdominal field, 61% of 56 patients irradiated over the thoracic field, 64% of 47 patients irradiated over the cerebral region. It is interesting to note that irrespective of the radiated field, the prevalence was rather high.…”

Section: Discussionmentioning

confidence: 99%

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

Enblom

Axelsson

Steineck

et al. 2008

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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.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Enblom

Axelsson

Steineck

et al. 2008

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“…The role of antiemetics given on an as-needed basis has been investigated in three randomized trials [24,30,32].…”

Section: Rescue Therapymentioning

confidence: 99%

“…In the latest study including 288 patients, the value of prophylactic versus rescue tropisetron was evaluated in fractionated radiotherapy of moderate or high emetogenic radiation fields [32]. Although no stratification in regard of radiation fields were conducted, it can be concluded that prophylactic tropisetron was superior over rescue tropisetron in regard to vomiting (risk 2.19 higher for rescue, p= 0.001) and nausea (risk 1.89 higher for rescue, p=0.009).…”

Section: Rescue Therapymentioning

confidence: 99%

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

Feyer

Maranzano

Molassiotis

et al. 2010

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Radiation-induced nausea and vomiting (RINV) are still often underestimated by radiation oncologists. However, as many as 50-80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting, depending on the site of irradiation. Fractionated RT may involve up to 40 fractions over a 6-8-week period, and prolonged symptoms of nausea and vomiting affect quality of life. Furthermore, uncontrolled nausea and vomiting may result in patients delaying or refusing further radiotherapy. Incidence and severity of nausea and vomiting depend on RT-related factors (irradiated site, single and total dose, fractionation, irradiated volume, radiotherapy techniques) and patient-related factors (gender, general health of the patient, age, concurrent or recent chemotherapy, psychological state, tumor stage). The new proposed guideline from the Multinational Association of Supportive Care in Cancer and European Society of Clinical Oncology summarises the updated data from the literature and takes into consideration the existing guidelines. According to the irradiated area (the most frequently studied risk factor), the proposed guideline divided these areas into four levels of emetogenic risk: high, moderate, low and minimal. In fact, the emetogenicity of radiotherapy regimens and recommendations for the appropriate use of antiemetics including 5-hydroxytryptamine receptor antagonists and steroids are given in regard to the applied radiotherapy or radiochemotherapy regimen. This updated guideline offers guidance to the treating physicians for effective antiemetic therapies in RINV.

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Antiemetic Prophylaxis of Radiotherapy-Induced Nausea and Vomiting

Aapro

Jordan

Feye

2013

Prevention of Nausea and Vomiting in Cancer Patients

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Prophylactic Tropisetron versus Rescue Tropisetron in Fractionated Radiotherapy to Moderate or High Emetogenic Areas: A Prospective Randomized Open Label Study in Cancer Patients

Abstract: Higher numbers of patients receiving prophylactic tropisetron completed RT with lower incidence of nausea and vomiting than those in the rescue tropisetron group.

Cited by 13 publications

References 11 publications

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

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

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

Antiemetic Prophylaxis of Radiotherapy-Induced Nausea and Vomiting

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