Delayed nausea and vomiting continue to reduce patients' quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment
Delayed nausea and vomiting continue to reduce patients' quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment
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DOI：
10.1200/jco.2006.05.6382
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发表时间：
2006-09-20
影响因子：
45.3
通讯作者：
Herrstedt, Jorn
中科院分区：
文献类型：
--
作者：
Bloechl-Daum, Brigitte;Deuson, Robert R.;Herrstedt, Jorn
目的化疗引起的恶心呕吐（CINV）是肿瘤化疗的主要不良反应。我们比较了急性（化疗后24小时内）和延迟（化疗后2 - 5天）CINV对高度或中度致吐化疗（HEC和MEC，分别）后患者的生活质量（QoL）的影响。Patients and MethodsThis前瞻性，多中心，多国研究进行了14个医疗实践的癌症患者进行HEC或MEC治疗。患者在日记中记录恶心和呕吐发作。患者在基线和第6天完成功能性生活指数-呕吐（FLIE）问卷。结果共有298例患者可评估（67例HEC患者，231例MEC患者）。36.4%的患者报告呕吐（13.2%急性，32.5%延迟），59.7%的患者报告恶心（36.2%急性，54.3%延迟）。HEC患者报告的平均FLIE总分显著低于MEC患者（分别为95.5 v107.8; P = 0.0049）。在所有患者中，恶心评分显著低于呕吐评分（分别为50.0和55.3; P = 0.0097）。在化疗后24小时内未发生呕吐或恶心的173例患者中，22.9%的患者报告了延迟CINV对日常生活的影响。甚至在最初24小时内未出现恶心和呕吐的患者亚组中也是如此。根据这项研究的FLIE结果，恶心对患者日常生活的负面影响比呕吐更大。
PurposeChemotherapy-induced nausea and vomiting (CINV) are major adverse effects of cancer chemotherapy. We compared the impact of acute (during the first 24 hours postchemotherapy) and delayed (days 2 through 5 postchemotherapy) CINV on patients' quality of life (QoL) after highly or moderately emetogenic chemotherapy (HEC and MEC, respectively).Patients and MethodsThis prospective, multicenter, multinational study was conducted in 14 medical practices on cancer patients undergoing either HEC or MEC treatment. Patients recorded episodes of nausea and vomiting in a diary. Patients completed the Functional Living Index-Emesis (FLIE) questionnaire at baseline and on day 6.ResultsA total of 298 patients were assessable (67 HEC patients, 231 MEC patients). Emesis was reported by 36.4% of patients (13.2% acute, 32.5% delayed) and nausea by 59.7% (36.2% acute, 54.3% delayed). HEC patients reported significantly lower mean FLIE total score than MEC patients (95.5 v 107.8 respectively; P =.0049). Among all patients, the nausea score was significantly lower than the vomiting score (50.0 and 55.3, respectively; P =.0097). Of the 173 patients who experienced neither vomiting nor nausea during the first 24 hours postchemotherapy, 22.9% reported an impact of CINV on daily life caused by delayed CINV.ConclusionCINV continues to adversely affect patients' QoL despite antiemetic therapy even after treatment with only moderately emetogenic chemotherapy regimens, and even in the subgroup of patients who do not experience nausea and vomiting during the first 24 hours. On the basis of the FLIE results in this study, nausea had a stronger negative impact on patients' daily lives than vomiting.