Control and Risk Factors of Nausea and Vomiting in Patients With Cervical Cancer Receiving Radiotherapy
Control and Risk Factors of Nausea and Vomiting in Patients With Cervical Cancer Receiving Radiotherapy
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DOI：
10.21873/anticanres.15800
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发表时间：
2022-06-01
影响因子：
2
通讯作者：
Suzuki, Akio
中科院分区：
文献类型：
--
作者：
Uno, Akane;Yamamoto, Senri;Suzuki, Akio
背景/目的：恶心和呕吐是癌症放射治疗中最令人痛苦的两个不良事件。本研究旨在探讨宫颈癌放疗患者恶心呕吐的控制率及相关危险因素。患者和方法：本回顾性研究调查了单独放疗或联合顺铂治疗的宫颈癌患者。单独接受放疗的患者不给予止吐前药物治疗，而接受放疗同时每周顺铂（40 mg/m(2)）的患者给予包括格拉司琼和地塞米松的止吐治疗。采用多因素logistic回归分析确定非完全缓解（CR）的危险因素。结果：多因素分析表明，年龄较小和伴随的每周顺铂治疗是放疗患者5周治疗期间非cr的重要因素。年轻患者（65岁）达到CR的比例（合并顺铂：27% vs. 67%, p=0.049；单独放疗：62% vs. 91%, p=0.166）。然而，除了单独接受放射治疗的年龄在50 ~ 65岁之间的患者外，所有组在5周治疗期间达到CR的患者比例都不足。结论：年轻宫颈癌单独放疗患者应考虑预防止吐。此外，在5-羟色胺3型受体拮抗剂和地塞米松的基础上，神经激肽-1受体拮抗剂可作为宫颈癌放疗患者的止吐预防治疗，同时每周给药40 mg/m(2)顺铂。
Background/Aim: Nausea and vomiting are two of the most distressing adverse events of cancer radiotherapy. The aim of this study was to examine the control rate and risk factors associated with nausea and vomiting in patients with cervical cancer receiving radiotherapy. Patients and Methods: This retrospective study examined patients with cervical cancer who received radiotherapy alone or with concomitant cisplatin. Patients who received radiotherapy alone were not administered antiemetic premedication, while patients who received radiotherapy with concomitant weekly cisplatin (40 mg/m(2)) were administered antiemetic therapy comprising granisetron and dexamethasone. Risk factors for non-complete response (CR) were identified using multivariate logistic regression analysis. Results: Multivariate analysis indicated that younger age and concomitant weekly cisplatin were significant factors associated with non-CR across 5 weeks of treatment in patients who received radiotherapy. The proportion achieving CR among younger patients (65 years) (Concomitant cisplatin: 27% vs. 67%, p=0.049; Radiotherapy alone: 62% vs. 91%, p=0.166). However, the proportion of patients achieving CR across 5 weeks of treatment was insufficient in all groups except for those aged > 65 years who received radiotherapy alone. Conclusion: Antiemetic prophylaxis should be considered for younger patients with cervical cancer undergoing radiotherapy alone. Further, neurokinin-1 receptor antagonist should be added to 5-hydroxytryptamine type-3 receptor antagonist and dexamethasone as antiemetic prophylactic therapy for patients with cervical cancer undergoing radiotherapy with concomitant weekly doses of 40 mg/m(2) cisplatin.