Insight in the prediction of chemotherapy-induced nausea

James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
Supportive Care in Cancer (Impact Factor: 2.5). 08/2009; 18(7):869-76. DOI: 10.1007/s00520-009-0723-2
Source: PubMed

ABSTRACT To identify risk factors for chemotherapy-related nausea.
We examined risk factors for nausea in 1,696 patients from three multicenter studies conducted from 1998 to 2004. All patients were beginning a chemotherapy regimen containing cisplatin, carboplatin, or doxorubicin. Nausea was assessed on a 1-7 scale four times a day for 4 days by diary.
First, average nausea for breast cancer patients receiving doxorubicin (mean = 2.31) was significantly greater than for other patients receiving doxorubicin (mean = 1.82), patients receiving cisplatin (mean = 1.88), and patients receiving carboplatin (mean = 1.45), Ps < 0.01. Second, mean nausea decreased steadily with age, P < 0.0001. Third, patients rating themselves more susceptible to nausea had significantly more nausea (adjusted mean = 2.51) than patients rating themselves less susceptible (adjusted mean = 1.92) and were 2.8 times more likely to experience severe nausea, Ps < 0.0001. Fourth, expected nausea was a significant predictor of average nausea, P = 0.034, but not severe nausea, P = 0.31. Last, no evidence that gender is a significant predictor of nausea in 299 patients with gender neutral cancers, P = 0.35.
Specific patient characteristics, especially younger age and perceived susceptibility to nausea, can help clinicians in the early identification of patients who are more susceptible to treatment-related nausea.

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    • "The main risk factor for the degree of CINV is the emetogenic potential of the chemotherapeutic agents (Jordan, Kasper, & Schmoll, 2005). However, several patient-related features have been identified, such as other medical disorders, depression , low alcohol intake, dysfunctional family relationships, young age, ethnicity, and genetic makeup (Bouganim et al., 2012; Bourdeanu et al., 2012; Molassiotis, Stamataki, & Kontopantelis, 2013; Roscoe et al., 2010; Shih, Wan, & Chan, 2009). "
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    ABSTRACT: The importance of nursing theory and models for the development of the nursing profession is becoming increasingly evident in literature. This article demonstrates the use of the Betty Neuman Systems Model (NSM) to assess, as well as determine the predictors of chemotherapy-induced nausea and vomiting (CINV) in patients diagnosed with breast cancer receiving doxorubicin-based chemotherapy. The selection of the model for practice reflects the congruency between the level of severity of CINV and the patient-related risk factors. In addition, the NSM was used to determine the appropriate nursing interventions necessary to strengthen the flexible lines of defense and the lines of resistance in addition to maintaining system stability.
    Research and theory for nursing practice 11/2013; 27(4):296-304. DOI:10.1891/1541-6577.27.4.296 · 0.61 Impact Factor
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    • "CINV is a complicated condition that is affected by many factors, including emetogenicity of chemotherapy regimens (CRegs) and patient-related factors (e.g. young age, female gender, prior CINV experiences, histories of morning and motion sickness, low alcohol use, and presence of anxiety, fatigue and labyrinthitis) (Hesketh, 1999; Lohr, 2008; Molassiotis et al., 2002; National Comprehensive Cancer Network, c2011; Pollera and Giannarelli, 1989; Roscoe et al., 2010; Shih et al., 2009). Some risk factors, such as anxiety and fatigue, are subjective in nature and difficult to quantify. "
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    ABSTRACT: Many risk factors exist for chemotherapy-induced nausea and vomiting (CINV). This study utilized a multivariate projection technique to identify which risk factors were predictive of CINV in clinical practice. A single-centre, prospective, observational study was conducted from January 2007~July 2010 in Singapore. Patients were on highly (HECs) and moderately emetogenic chemotherapies with/without radiotherapy. Patient demographics and CINV risk factors were documented. Daily recording of CINV events was done using a standardized diary. Principal component (PC) analysis was performed to identify which risk factors could differentiate patients with and without CINV. A total of 710 patients were recruited. Majority were females (67%) and Chinese (84%). Five risk factors were potential CINV predictors: histories of alcohol drinking, chemotherapy-induced nausea, chemotherapy-induced vomiting, fatigue and gender. Period (ex-/current drinkers) and frequency of drinking (social/chronic drinkers) differentiated the CINV endpoints in patients on HECs and anthracycline-based, and XELOX regimens, respectively. Fatigue interference and severity were predictive of CINV in anthracycline-based populations, while the former was predictive in HEC and XELOX populations. PC analysis is a potential technique in analyzing clinical population data, and can provide clinicians with an insight as to what predictors to look out for in the clinical assessment of CINV. We hope that our results will increase the awareness among clinician-scientists regarding the usefulness of this technique in the analysis of clinical data, so that appropriate preventive measures can be taken to improve patients' quality of life.
    06/2012; 28(2):81-91. DOI:10.5487/TR.2012.28.2.081
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    ABSTRACT: The joint recommendations for MASCC and ESMO in the prevention of chemotherapy and radiotherapy-induced nausea and vomiting are available to date in many languages. There was no French version. A working group of the European Fellowship for Pharmacists (EFP) and the Association francophone pour les soins oncologiques de support (AFSOS — French-speaking Association for Supportive Care in Cancer) through Specific Working Groups, has supported the translation to make it available to Frenchspeaking practitioners. The translation reproduces the recommendations published in 2010, in the state.
    Oncologie 05/2012; 14(5). DOI:10.1007/s10269-012-2141-1 · 0.08 Impact Factor
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