The Emesis Trial: Depressive Glioma Patients Are More Affected by Chemotherapy-Induced Nausea and Vomiting

Abstract

PurposeGlioma patients face a limited life expectancy and at the same time, they suffer from afflicting symptoms and undesired effects of tumor treatment. Apart from bone marrow suppression, standard chemotherapy with temozolomide causes nausea, emesis and loss of appetite. In this pilot study, we investigated how chemotherapy-induced nausea and vomiting (CINV) affects the patients' levels of depression and their quality of life.MethodsIn this prospective observational multicentre study (n = 87), nausea, emesis and loss of appetite were evaluated with an expanded MASCC questionnaire, covering 10 days during the first and the second cycle of chemotherapy. Quality of life was assessed with the EORTC QLQ-C30 and BN 20 questionnaire and levels of depression with the PHQ-9 inventory before and after the first and second cycle of chemotherapy.ResultsCINV affected a minor part of patients. If present, it reached its maximum at day 3 and decreased to baseline level not before day 8. Levels of depression increased significantly after the first cycle of chemotherapy, but decreased during the further course of treatment. Patients with higher levels of depression were more severely affected by CINV and showed a lower quality of life through all time-points.ConclusionWe conclude that symptoms of depression should be perceived in advance and treated in order to avoid more severe side effects of tumor treatment. Additionally, in affected patients, delayed nausea was most prominent, pointing toward an activation of the NK1 receptor. We conclude that long acting antiemetics are necessary totreat temozolomide-induced nausea.

Depression and Quality of Life in Patients with Gliomas: A Narrative Review

“…However, even with maximal therapy, the 5-year survival rate is < 5%; therefore, the present treatment goal is to maximize QoL [ 70 ]. Many studies have highlighted the necessity to consider QoL issues in the treatment of gliomas [ 74 , 75 ]. In a prospective multicenter study ( n = 87), patients with gliomas treated with chemotherapy had higher levels of depression, higher chemotherapy-induced nausea and vomiting, and lower QoL at all time points.…”

“…In a prospective multicenter study ( n = 87), patients with gliomas treated with chemotherapy had higher levels of depression, higher chemotherapy-induced nausea and vomiting, and lower QoL at all time points. Therefore, the researchers suggested that depressive symptoms in patients with cancers should be recognized and treated to avoid the more serious side effects of cancer treatment [ 75 ]. QoL encompasses symptom control; functional status, such as the ability to carry out activities of daily living; emotional health, such as the control of depression and anxiety; and social health, including the possibility of maintaining personal, family, and social roles and gaining access to social support [ 76 ].…”

Risk factors, prognostic potency, and longitudinal variation of anxiety and depression in postoperative glioma patients

“…Moreover, treatments of glioma (such as surgery, chemotherapy, etc.) may impose negative influences on their mental health, too ( 15 , 16 ). Therefore, the mental health of glioma patients is a major issue currently.…”