Chemotherapy-induced nausea and vomiting in daily clinical practice: a community hospital-based study
Chemotherapy-induced nausea and vomiting in daily clinical practice: a community hospital-based study
复制标题
DOI：
10.1007/s00520-010-1073-9
复制
发表时间：
2012-01-01
影响因子：
3.1
通讯作者：
Aaronson, Neil K.
中科院分区：
文献类型：
--
作者：
Hilarius, Doranne L.;Kloeg, Paul H.;Aaronson, Neil K.
化疗引起的恶心和呕吐（CINV）是癌症化疗的主要不良反应。本研究调查了：（1）在日常临床实践中CINV对患者健康相关生活质量（HRQL）的影响;（2）患者特征和止吐药类型与CINV之间的关联;（3）CINV在医生决定修改止吐治疗中的作用。在三个连续的化疗周期中，患者使用日记记录恶心、呕吐和止吐药的使用情况。对于每个周期，在接受化疗前1天和化疗后7天进行这些评级。在每个治疗周期的第6天，使用功能性生活指数-呕吐（FLIE）问卷评估CINV对患者HRQL的影响。由治疗护士记录止吐药的使用（变化）。患者入选时间为2005年5月至2007年5月，共有277例患者入选本研究。在第一个治疗周期中，分别有39%和68%的患者报告了急性和迟发性恶心。急性和迟发性呕吐的可比数字分别为12%和23%。在第一个和随后的治疗周期中，大约三分之一的患者表示CINV对他们的日常生活产生了重大影响。女性患者和年轻患者报告的CINV显著多于男性和老年患者。在所有治疗周期中，接受含蒽环类药物的中度致吐化疗的患者比接受高度致吐化疗的患者报告更多的急性恶心。急性呕吐与（即，额外的）止吐治疗。迟发性CINV并不影响止吐治疗，CINV仍然是一个对患者日常生活产生不利影响的问题。CINV在女性和年轻患者中更严重。在日常临床实践中，急性CINV，而不是延迟CINV，导致止吐治疗的变化。鉴于急性和延迟性CINV对日常生活的影响，应更加注意调整止吐治疗，以涵盖化疗周期后期的CINV投诉。
Chemotherapy-induced nausea and vomiting (CINV) are major adverse effects of cancer chemotherapy. This study investigated: (1) the impact of CINV on patients' health-related quality of life (HRQL) in daily clinical practice; (2) the association between patient characteristics and type of antiemetics and CINV; and (3) the role of CINV in physicians' decisions to modify antiemetic treatment.This prospective, multicenter study was conducted in nine general hospitals in the Netherlands. During three consecutive chemotherapy cycles, patients used a diary to record episodes of nausea, vomiting and antiemetic use. For each cycle, these ratings were made 1 day prior to and 7 days after having received chemotherapy. The influence of CINV on patients' HRQL was evaluated with the Functional Living Index-Emesis (FLIE) questionnaire at day 6 of each treatment cycle. (Changes in) antiemetic use were recorded by the treating nurse. Patient inclusion took place between May 2005 and May 2007.Two hundred seventy-seven patients were enrolled in the study. Acute and delayed nausea during the first treatment cycle was reported by 39% and 68% of the patients, respectively. The comparable figures for acute and delayed vomiting were 12% and 23%. During the first and subsequent treatment cycle, approximately one-third of the patients indicated that CINV had a substantial impact on their daily lives. Female patients and younger patients reported significantly more CINV than male and older patients. At all treatment cycles, patients receiving treatment with moderately emetogenic chemotherapy, containing anthracycline, reported more acute nausea than patients receiving highly emetogenic chemotherapy. Acute vomiting was associated significantly with change in (i.e., additional) antiemetic treatment. Delayed CINV did not influence antiemetic treatment.CINV continues to be a problem that adversely affects the daily lives of patients. CINV is worse in women and in younger patients. In daily clinical practice, acute CINV, but not delayed CINV, results in changes in antiemetic treatment. In view of the effects of not only acute, but also delayed CINV on daily life, more attention should be paid to adjustment of antiemetic treatment to cover CINV complaints, later during the chemotherapy cycle.