Abstract:

Background and purpose: In patients with advanced non-small cell lung cancer (NSCLC) who receive platinum-containing dual-drug chemotherapy with high emetic risk, a significant number of patients experience nausea and vomiting after chemotherapy, even if they are treated with a triple or quadruple antiemetic regimen. The low-frequency electrical stimulator for antiemesis is a wearable electronic antiemesis device, which can effectively reduce nausea and vomiting caused by various reasons. However, no studies have investigated whether the combination of three antiemetic drugs with low-frequency electrical stimulator can further improve the control rate of chemotherapy-induced nausea and vomiting (CINV). Therefore, the aim of this study was to assess the efficacy and tolerability of low-frequency electrical stimulator for antiemesis plus standard antiemetics following highly emetogenic chemotherapy in patients with NSCLC. Methods: Data of patients with advanced NSCLC who received first-line hyperemetic chemotherapy at Peking University International Hospital from December 1, 2019 to December 30, 2022 were retrospectively collected. Patients who correctly wore low-frequency electrical stimulator for antiemesis were selected as the observation group, and chemotherapy patients who did not wear low-frequency electrical stimulator were selected as the control group. Clinical characteristics, occurrence of nausea and vomiting after chemotherapy and functional living index-emesis (FLIE) questionnaire were collected. SPSS 20.0 was used for statistical analysis to compare the vomiting complete response rate, nausea incidence and FLIE score between the two groups. Results: Compared with the control group, the no nausea rate (66.3% vs 51.1%, P=0.036) and the complete response rate of vomiting (83.7% vs 66.3%, P=0.006) in experimental group were significantly increased. At 24-120 h after chemotherapy, the complete response rate of vomiting at the delayed stage increased conspicuously in the observation group (88.0% vs 69.6%, P=0.002). At this stage, the proportion of patients without nausea in the observation group was also significantly higher (73.9% vs 57.6%, P=0.020). The total FLIE scores were conspicuously higher in the observation group than in the control group (106.05±15.35 vs 95.04±20.02, P=0.020). Conclusion: The results suggest that, on the basis of the triple antiemesis regimen, wearing the low-frequency electrical stimulator can significantly improve the control level of CINV and the quality of life of NSCLC patients, which can be an effective supplement to the triple antiemesis regimen.

Key words: Low-frequency electrical acupoint stimulation, Nausea and vomiting, Chemotherapy, Non-small cell lung cancer