Anticipatory Nausea, Risk Factors, and Its Impact on Chemotherapy-Induced Nausea and Vomiting: Results From the Pan European Emesis Registry Study
Anticipatory Nausea, Risk Factors, and Its Impact on Chemotherapy-Induced Nausea and Vomiting: Results From the Pan European Emesis Registry Study
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DOI：
10.1016/j.jpainsymman.2015.12.317
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发表时间：
2016-06-01
影响因子：
4.7
通讯作者：
Aapro, Matti
中科院分区：
文献类型：
--
作者：
Molassiotis, Alexander;Lee, Paul H.;Aapro, Matti
语境。预期（化疗前）恶心（AN）是一种典型的条件症状，目前的止吐药效果不佳。已完成最少的工作来评估其危险因素及其对化疗引起的恶心和呕吐 (CINV) 的影响。 目标。评估 AN 的风险因素并评估其对 CINV 发展的影响。方法。我们分析了在八个欧洲国家进行的三个化疗周期的前瞻性观察性多中心研究的数据 (n = 991)。在化疗前收集患者/治疗特征。化疗前还收集了恶心/呕吐史（是/否）、患者对 CINV 的期望（0-100 mm 视觉模拟量表，[VAS]）和化疗前焦虑（0-100 mm VAS）。每个化疗周期中患者完成的日记获得了化疗前 24 小时内的 AN 信息以及化疗后五天内每天的恶心和呕吐（呕吐发作和恶心严重程度）信息 (0-100 mm VAS)。 结果。 8.3%-13.8% 的患者报告出现 AN，每个周期的频率和强度都在增加。 VAS 中 AN 每增加 1 mm 与 CINV 可能性增加 2%-13% 显着相关（所有 P 值 < 0.05）。第 1 周期中 AN 的关键预测因素包括转移性疾病和化疗前焦虑。然而，后续周期中 AN 的预测因素包括化疗前焦虑以及前一个周期中的 AN 和 CINV 经历，后者是最强的预测因素（周期内 CINV 结果的比值比 = 3.30-4.09）。结论。 AN 是一种具有挑战性的症状，其预防需要考虑在前几个周期中更好地预防 CINV 以及管理化疗前的焦虑。 (C) 2016 年美国临终关怀和姑息医学学会。由爱思唯尔公司出版。保留所有权利。
Context. Anticipatory (prechemotherapy) nausea (AN) is a classic conditioned symptom not responding well to current antiemetics. Minimal work has been done to assess its risk factors and impact on chemotherapy-induced nausea and vomiting (CINV).Objectives. To evaluate risk factors for AN and assess its impact on CINV development.Methods. We analyzed data (n = 991) from a prospective observational multisite study in eight European countries over three cycles of chemotherapy. Patient/treatment characteristics were collected before chemotherapy. History of nausea/vomiting (yes/no), patient expectation of CINV (0-100 mm visual analog scale, [VAS]), and prechemotherapy anxiety (0-100 mm VAS) also were collected before chemotherapy. A patient-completed diary during each chemotherapy cycle obtained information on AN in the 24 hours before chemotherapy administration and nausea and vomiting (episodes of vomiting and severity of nausea) daily for five days after administration of chemotherapy (0-100 mm VAS).Results. AN was reported by 8.3%-13.8% of patients, increasing in frequency and intensity over each cycle. Every 1 mm increase in AN on the VAS was significantly associated with 2%-13% of increase in the likelihood of CINV (all P-values < 0.05). Key predictors of AN in Cycle 1 included metastatic disease and prechemotherapy anxiety. However, predictors of AN in subsequent cycles included prechemotherapy anxiety and AN and CINV experience in the previous cycle, the latter being the strongest predictor (odds ratio = 3.30-4.09 for CINV outcomes over the cycles).Conclusion. AN is a challenging symptom, and its prevention needs to consider better CINV prevention in the previous cycles as well as managing prechemotherapy anxiety. (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.