Chemotherapy-induced nausea and vomiting among cancer patients in Shanghai: a cross-sectional study

doi:10.19401/j.cnki.1007-3639.2023.11.006

China Oncology ›› 2023, Vol. 33 ›› Issue (11): 1009-1017.doi: 10.19401/j.cnki.1007-3639.2023.11.006

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Chemotherapy-induced nausea and vomiting among cancer patients in Shanghai: a cross-sectional study

ZENG Cheng¹^,²(), JIN Yizi¹^,², LI Ting¹, ZHANG Zhen³, LIANG Xiaohua⁴, TANG Xi⁵, LIU Tianshu⁶, LI Qi⁷, SHEN Zan⁸, JIANG Bin⁹, WANG Liwei¹⁰, ZHANG Jun¹¹, CHEN Siyu¹², ZHOU Caicun¹³, GAO Yong¹⁴, ZANG Yuansheng¹⁵, LI Hengyu¹⁶, DONG Yuchao¹⁷, ZHAN Xianbao¹⁸, ZHONG Yi¹⁹, LIU Lingshuang²⁰, QIN Yuenong²¹, HU Xichun¹, ZHANG Jian¹^,²()

1. Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
2. Phase Ⅰ Clinical Trial Center, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
3. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai Key Laboratory of Radiation Oncology, Shanghai Clinical Research Center for Radiation Oncology, Shanghai 200032, China
4. Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China
5. Department of Oncology, Huadong Hospital, Fudan University, Shanghai 200040, China
6. Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
7. Department of Oncology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
8. Department of Oncology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
9. Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
10. Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
11. Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
12. Department of Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
13. Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
14. Department of Oncology, Shanghai East Hospital, School of Medicine of Tongji University, Shanghai 200120, China
15. Department of Medical Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai 200070, China
16. Department of Throat and Breast, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
17. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
18. Department of Oncology, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
19. Department of Oncology, Shanghai TCM-integrated Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
20. Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
21. Breast Department of Integrated Traditional Chinese and Western Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China

Received:2023-05-02 Revised:2023-09-10 Online:2023-11-30 Published:2023-12-14

Abstract

Abstract:

Background and purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe damage to body functions and even lead to death. The prevention of CINV is critically important in patients receiving emetogenic chemotherapy regimen. This study aimed to investigate the prevalence and treatment of CINV in Grade-A tertiary hospitals in Shanghai and explore risk factors of CINV to improve its management. Methods: The clinical data of 376 cancer patients in Grade-A tertiary hospitals in Shanghai from October 2022 to December 2022 were collected retrospectively. The questionnaire was used to conduct a cross-sectional study. The univariate and multivariable logistic regression models were used to evaluate the influencing factors of CINV. Results: The management and coincidence of the guideline in 2022 significantly improved compared to five years ago. For patients receiving high-emetic-risk chemotherapy regimen, the coincidence of the guideline increased from 21.6% to 67.0%. For patients receiving moderate-emetic-risk chemotherapy regimen, the neurokinin-1 (NK-1) receptor antagonist was not significantly associated with CINV. Multivariable analysis showed that the chemotherapy regimen was the only risk factor for CINV during the whole period (P<0.05). Conclusion: The chemotherapy regimen is the main risk factor for CINV. To control CINV better, clinical practitioners should focus on the intrinsic risk of chemotherapy regimens preferentially, estimate the risk and adhere better to guidelines.

Key words: Chemotherapy-induced nausea and vomiting, Cancer, Cross-sectional study

CLC Number:

R730.6

ZENG Cheng, JIN Yizi, LI Ting, ZHANG Zhen, LIANG Xiaohua, TANG Xi, LIU Tianshu, LI Qi, SHEN Zan, JIANG Bin, WANG Liwei, ZHANG Jun, CHEN Siyu, ZHOU Caicun, GAO Yong, ZANG Yuansheng, LI Hengyu, DONG Yuchao, ZHAN Xianbao, ZHONG Yi, LIU Lingshuang, QIN Yuenong, HU Xichun, ZHANG Jian. Chemotherapy-induced nausea and vomiting among cancer patients in Shanghai: a cross-sectional study[J]. China Oncology, 2023, 33(11): 1009-1017.

Figures/Tables 7

Fig. 1

Tab. 1

Tab. 2

Fig. 2

Tab. 3

Tab. 4

Tab. 5

References 17

[1]	JORDAN K, JAHN F, AAPRO M. Recent developments in the prevention of chemotherapy-induced nausea and vomiting (CINV): a comprehensive review[J]. Ann Oncol, 2015, 26(6): 1081-1090. doi: S0923-7534(19)31811-3 pmid: 32018835
[2]	LYONS E, LINE C, LEE J J. Developing drugs for prevention of chemotherapy-induced nausea and vomiting: draft guidance from the FDA[J]. Clin Cancer Res, 2021, 27(22): 6072-6074. doi: 10.1158/1078-0432.CCR-21-1941
[3]	GRASSI L, BERARDI M A, RUFFILLI F, et al. Role of psychosocial variables on chemotherapy-induced nausea and vomiting and health-related quality of life among cancer patients: a European study[J]. Psychother Psychosom, 2015, 84(6): 339-347. doi: 10.1159/000431256 pmid: 26402426
[4]	NATALE J J. Overview of the prevention and management of CINV[J]. Am J Manag Care, 2018, 24(18 Suppl): S391-S397. pmid: 30328690
[5]	PIECHOTTA V, ADAMS A, HAQUE M, et al. Antiemetics for adults for prevention of nausea and vomiting caused by moderately or highly emetogenic chemotherapy: a network meta-analysis[J]. Cochrane Database Syst Rev, 2021, 11(11): CD012775.
[6]	BADARUDIN N S, MOHAMED SHAH N, MOHD KASSIM K N B, et al. A retrospective study on chemotherapy-induced nausea and vomiting in highly/moderately emetogenic chemotherapy: incidence and prescribing practice[J]. Support Care Cancer, 2022, 30(6): 5339-5349. doi: 10.1007/s00520-022-06956-0 pmid: 35290510
[7]	RAZVI Y, CHAN S, MCFARLANE T, et al. ASCO, NCCN, MASCC/ESMO: a comparison of antiemetic guidelines for the treatment of chemotherapy-induced nausea and vomiting in adult patients[J]. Support Care Cancer, 2019, 27(1): 87-95. doi: 10.1007/s00520-018-4464-y pmid: 30284039
[8]	上海市抗癌协会癌症康复与姑息专业委员会. 化疗所致恶心呕吐全程管理上海专家共识(2018年版)[J]. 中国癌症杂志, 2018, 28(11): 946-960.
	Cancer Rehabilitation and Palliative Care Committee of Shanghai Anti-Cancer Association. Shanghai Consensus Guidelines for the Management of chemotherapy-induced nausea and vomiting (2018 edition)[J]. Chin Oncol 2018, 28(11): 946-960.
[9]	SUN Y, ZHENG Y Z, YANG X Y, et al. Incidence of chemotherapy-induced nausea and vomiting among cancer patients receiving moderately to highly emetogenic chemotherapy in cancer centers in Sichuan, China[J]. J Cancer Res Clin Oncol, 2021, 147(9): 2701-2708. doi: 10.1007/s00432-021-03554-1 pmid: 33586045
[10]	COOKSLEY T, GIROTRA M, GINEX P, et al. Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of immune checkpoint inhibitor endocrinopathies and the role of advanced practice providers in the management of immune-mediated toxicities[J]. Support Care Cancer, 2020, 28(12): 6175-6181. doi: 10.1007/s00520-020-05709-1
[11]	National Comprehensive Cancer Network. NCCN Guidelines Version 1. 2023 Antiemesis[EB/OL]. (2023-03-23)[2023-08-30]. https://www.nccn.org/guidelines.
[12]	HESKETH P J, GRUNBERG S M, GRALLA R J, et al. The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin--the Aprepitant Protocol 052 Study Group[J]. J Clin Oncol, 2003, 21: 4112-4119. doi: 10.1200/JCO.2003.01.095 pmid: 14559886
[13]	POLI-BIGELLI S, RODRIGUES-PEREIRA J, CARIDES A D, et al. Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America[J]. Cancer, 2003, 97: 3090-3098. doi: 10.1002/cncr.v97:12
[14]	BERGER M J, ETTINGER D S, ASTON J, et al. NCCN guidelines insights: antiemesis, version 2. 2017[J]. J Natl Compr Canc Netw, 2017, 15(7): 883-893. doi: 10.6004/jnccn.2017.0117
[15]	许晶, 李洁, 张美静, 等. 化疗相关性恶心呕吐的回顾性研究[J]. 临床肿瘤学杂志, 2018, 23(5): 440-443.
	XU J, LI J, ZHANG M J, et al. Adherence to NCCN antiemesis guideline for chemotherapy induced nausea and vomiting: a retrospective study in changhai hospital[J]. Chin Clin Oncol, 2018, 23(5):440-443.
[16]	ZHANG Y X, YANG Y P, ZHANG Z H, et al. Neurokinin-1 receptor antagonist-based triple regimens in preventing chemotherapy-induced nausea and vomiting: a network meta-analysis[J]. J Natl Cancer Inst, 2017, 109(2): djw217. doi: 10.1093/jnci/djw217
[17]	SEKINE I, SEGAWA Y, KUBOTA K, et al. Risk factors of chemotherapy-induced nausea and vomiting: index for personalized antiemetic prophylaxis[J]. Cancer Sci, 2013, 104(6): 711-717. doi: 10.1111/cas.2013.104.issue-6

Characteristic	Number of patients
Gender
Female	220 (58.5)
Male	156 (41.5)
Age/year
≤60	217 (57.7)
>60	159 (42.3)
Cancer type
Lung cancer	126 (33.5)
Breast cancer	103 (27.4)
Gastric cancer	113 (30.1)
Gynecologic cancer	34 (9.0)
Cycle of chemotherapy
The first	95 (25.3)
The second	85 (22.6)
The third and above	196 (52.1)
Chemotherapy regimen
Low/minimal emetic risk chemotherapy	25 (6.6)
MEC	109 (29.0)
HEC	242 (64.4)
Cisplatin-based	89 (23.7)
Carboplatin-based	64 (17.0)
AC-based	56 (14.9)
Others	33 (8.8)
Antiemetic regimen
Quadruple regimen	34 (9.0)
Triple regimen	152 (40.4)
NK-1 RA-based	135 (35.9)
Olanzapine-based	17 (4.5)
Dual regimen	133 (35.4)
Single regimen	40 (10.6)
None	17 (4.5)

Chemotherapy regimen	Incidence of CINV					Coincidence of guideline^*
Chemotherapy regimen	Quadruple regimen	Triple regimen	Dual regimen	Single regimen	None	Coincidence of guideline^*
MEC		15/27 (55.6)	23/51 (45.1)	17/29 (58.6)	2/2 (100.0)	78/109 (71.6)
HEC	27/33 (81.8)	69/124 (55.6)	46/75 (61.3)	4/6 (66.7)	2/4 (50.0)	157/242 (64.9)
Cisplatin-based	15/18 (83.3)	25/47 (53.2)	7/19 (36.8)	3/4 (75)	1/1 (100.0)	65/89 (73.0)
Carboplatin-based	4/6 (66.7)	16/36 (44.4)	10/19 (52.6)	0/1 (0.0)	0/2 (0.0)	42/64 (65.6)
AC-based	1/2 (50)	17/22 (77.3)	23/30 (76.7)	1/1 (100.0)	1/1 (100.0)	24/56 (42.9)
Others	7/7 (100)	11/19 (57.9)	6/7 (85.7)			26/33 (78.8)

Characteristic	Univariate analysis		Multivariable analysis
Characteristic	OR (95% CI)	P value	OR (95% CI)	P value
Gender
Female	1
Male	0.862 (0.566-1.313)	0.490
Age/year
≤60	1
>60	1.124 (0.740-1.706)	0.584
Cancer type
Lung cancer	1
Breast cancer	0.921 (0.550-1.542)	0.754
Gastric cancer	0.728 (0.420-1.262)	0.258
Gynecologic cancer	1.069 (0.494-2.316)	0.865
Cycle of chemotherapy
The first	1
The second	1.276 (0.707-2.303)	0.418
The third and above	0.816 (0.494-1.347)	0.426
Chemotherapy regimen
Low/minimal emetic risk chemotherapy	1		1
MEC	2.921 (1.021-8.355)	0.046	2.921 (1.021-8.355)	0.046
HEC	2.769 (1.006-7.626)	0.049	2.769 (1.006-7.626)	0.049

Characteristic	Univariate analysis		Multivariable analysis
Characteristic	OR (95% CI)	P value	OR (95% CI)	P value
Gender
Female	1		1
Male	0.475 (0.309-0.729)	<0.001	1.175 (0.673-2.052)	0.571
Age/year
≤60	1
>60	0.821 (0.541-1.245)	0.353
Cancer type
Lung cancer	1		1
Breast cancer	0.819 (0.476-1.411)	0.472	0.477 (0.253-0.902)	0.023
Gastric cancer	2.544 (1.467-4.411)	0.001	1.488 (0.744-2.974)	0.261
Gynecologic cancer	3.065 (1.387-6.774)	0.006	1.468 (0.582-3.707)	0.416
Cycle of chemotherapy
The first	1
The second	0.973 (0.539-1.754)	0.927
The third and above	0.834 (0.508-1.369)	0.473
Chemotherapy regimen
Low/minimal emetic risk chemotherapy	1		1
MEC	1.590 (0.548-4.610)	0.393	1.585 (0.529-4.744)	0.411
HEC	4.000 (1.454-11.003)	0.007	4.385 (1.535-12.529)	0.006

Characteristic	Univariate analysis		Multivariable analysis
Characteristic	OR（95% CI）	P value	OR（95% CI）	P value
Gender
Female	1		1
Male	0.499 (0.329-0.758)	0.001	1.521 (0.897-2.578)	0.120
Age/year
≤60	1
>60	0.830 (0.549-1.253)	0.374
Cancer type
Lung cancer	1		1
Breast cancer	0.702 (0.421-1.168)	0.173	0.524 (0.287-0.956)	0.035
Gastric cancer	1.598 (0.921-2.773)	0.095	0.997 (0.498-1.996)	0.992
Gynecologic cancer	1.720 (0.766-3.860)	0.189	0.875 (0.342-2.239)	0.780
Cycle of chemotherapy
The first	1
The second	1.045 (0.576-1.896)	0.886
The third and above	0.787 (0.480-1.293)	0.344
Chemotherapy regimen
Low/minimal emetic risk chemotherapy	1		1
MEC	3.471 (1.287-9.359)	0.014	3.240 (1.170-8.973)	0.024
HEC	4.986 (1.921-12.938)	<0.01	5.485 (2.043-14.726)	0.001

Chemotherapy-induced nausea and vomiting among cancer patients in Shanghai: a cross-sectional study

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