Real-world emetic risk of chemotherapy and the corresponding antiemetic therapy in Japan: A study based on a nationwide database.
Real-world emetic risk of chemotherapy and the corresponding antiemetic therapy in Japan: A study based on a nationwide database.
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DOI：
10.1002/cnr2.1482
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Higashi T
中科院分区：
文献类型：
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作者：
Okuyama A;Boku N;Higashi T
化疗引起的恶心和呕吐（CINV）是癌症患者的主要问题，导致治疗效果不佳。本研究在真实的世界环境中按癌症类型评估了与静脉和口服化疗以及预防性止吐药物相关的呕吐风险。我们使用了2016年诊断出的癌症患者的卫生服务利用数据。纳入诊断时年龄至少20岁且开始第一个化疗疗程的患者。根据癌症类型确定化疗的呕吐风险，并根据临床实践指南进行分类。评估止吐药物处方。总体而言，172 133例患者进行了评估，其中121 103（70.4%）接受静脉化疗。46458例（27.0%）患者接受了高呕吐风险化疗（HEC）。HEC最常用于食管癌患者（80.3%），其次是恶性淋巴瘤（60.2%）和乳腺癌（53.8%）。60528例（35.2%）患者接受了中度呕吐风险化疗（MEC），主要用于治疗小细胞肺癌（59.9%）。与此同时，超过50%的胃癌、结直肠癌和胰腺癌患者的化疗是低呕吐风险化疗。在90%以上的小细胞肺癌、非小细胞肺癌、乳腺癌和食管癌患者中，HEC伴随三种药物止吐预防，而仅13.5%的恶性淋巴瘤患者接受CHOP（环磷酰胺、多柔比星、硫酸长春新碱和泼尼松龙）预防。CINV的风险因癌症类型而异。与MEC相比，HEC处方较少。大多数患者接受了推荐的止吐预防治疗。
Chemotherapy‐induced nausea and vomiting (CINV) is a major concern of patients with cancer, leading to suboptimal treatment. This study assessed the emetic risk associated with intravenous and oral chemotherapy and the prophylactic antiemetic drugs by cancer type in a real‐world setting. We used the health services utilisation data for patients with cancer diagnosed in 2016. Patients aged at least 20 years at the time of diagnosis and who started their first course of chemotherapy were included. The emetic risk of chemotherapy was determined according to the cancer type and was classified based on clinical practice guidelines. The prescription of antiemetic drugs was assessed. Overall, 172 133 patients were evaluated, of whom 121 103 (70.4%) received intravenous chemotherapy. High‐emetic‐risk chemotherapy (HEC) was prescribed in 46 458 (27.0%) patients. HEC was prescribed most for patients with oesophageal cancer (80.3%), followed by malignant lymphoma (60.2%) and breast cancer (53.8%). Moderate‐emetic‐risk chemotherapy (MEC) was prescribed in 60 528 (35.2%) patients and was mostly prescribed for small cell lung cancer (59.9%). Meanwhile, more than 50% of the chemotherapy prescribed for patients with gastric, colorectal, and pancreatic cancer was low‐emetic‐risk chemotherapy. HEC was accompanied by three‐drug antiemetic prophylaxis in more than 90% of patients with small cell lung, non‐small cell lung, breast, and oesophageal cancer, whereas only 13.5% of patients with malignant lymphoma were administered CHOP (cyclophosphamide, doxorubicin, vincristine sulphate, and prednisolone) with prophylaxis. The risk of CINV differs with cancer type. HEC was less prescribed compared with MEC. Most patients received the recommended anti‐emetic prophylaxis.