Skip to main content
Top
Published in: Supportive Care in Cancer 4/2016

01-04-2016 | Original Article

A novel prospective descriptive analysis of nausea and vomiting among patients receiving gastrointestinal radiation therapy

Authors: Michael Poon, Jonathan Hwang, Kristopher Dennis, Carlo DeAngelis, Liying Zhang, Hans Chung, Jordan Stinson, Shun Wong, Natalie Pulenzas, Edward Chow

Published in: Supportive Care in Cancer | Issue 4/2016

Login to get access

Abstract

Purpose

Nausea and vomiting are common side effects from radiotherapy that can interfere with gastrointestinal (GI) cancer patients’ quality of life (QOL). This study described the subjective experience of patients with radiation-induced nausea and vomiting (RINV) and its relation to QOL.

Methods

Forty-eight patients treated with abdominal radiotherapy alone or with concomitant chemoradiotherapy were followed in a prospective study. All episodes of nausea, vomiting, and antiemetic use were recorded daily for the treatment period and the week following completion of therapy. QOL was assessed weekly using the Functional Living Index—Emesis QOL Tool (FLIE) and the EORTC QLQ-C30 core questionnaire (C30).

Results

In total, 351 episodes of nausea severity, duration, onset time, and 154 outcomes of vomiting onset times and contents were documented. The median nausea severity experienced per episode was 5 (on a scale from 1 to 10), and the most common durations of nausea were 30 min or less and constant nausea all day and night. The most common location of nausea was the abdomen. Longer nausea duration, great nausea severities, and the location of nausea experienced had significant adverse relationships to multiple QOL items on both the FLIE and the C30. In addition, the onset timing and number of vomiting episodes were related to the majority of all FLIE and QOL scores.

Conclusion

Patient’s subjective experiences of RINV directly correlated to the worsening of QOL outcomes. The identification and amelioration of these RINV experiences could improve QOL.
Appendix
Available only for authorised users
Literature
1.
go back to reference Naeim A, Dy SM, Lorenz KA, Sanati H, Walling A, Asch SM (2008) Evidence-based recommendations for cancer nausea and vomiting. J Clin Oncol 26(23):3903–3910CrossRefPubMed Naeim A, Dy SM, Lorenz KA, Sanati H, Walling A, Asch SM (2008) Evidence-based recommendations for cancer nausea and vomiting. J Clin Oncol 26(23):3903–3910CrossRefPubMed
2.
go back to reference Basch E, Prestrud AA, Hesketh PJ, Kris MG, Feyer PC, Somerfield MR, et al (2011) Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 29(31):4189–4198CrossRefPubMed Basch E, Prestrud AA, Hesketh PJ, Kris MG, Feyer PC, Somerfield MR, et al (2011) Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 29(31):4189–4198CrossRefPubMed
3.
go back to reference Sagar SM (1991) The current role of anti-emetic drugs in oncology: a recent revolution in patient symptom control. Cancer Treat Rev 18(2):95–135CrossRefPubMed Sagar SM (1991) The current role of anti-emetic drugs in oncology: a recent revolution in patient symptom control. Cancer Treat Rev 18(2):95–135CrossRefPubMed
4.
go back to reference Sanger GJ, Andrews PL (2006) Treatment of nausea and vomiting: gaps in our knowledge. Auton Neurosci 129(1–2):3–16CrossRefPubMed Sanger GJ, Andrews PL (2006) Treatment of nausea and vomiting: gaps in our knowledge. Auton Neurosci 129(1–2):3–16CrossRefPubMed
5.
go back to reference Dubois A, Walker RI (1988) Prospects for management of gastrointestinal injury associated with the acute radiation syndrome. Gastroenterology 95(2):500–507PubMed Dubois A, Walker RI (1988) Prospects for management of gastrointestinal injury associated with the acute radiation syndrome. Gastroenterology 95(2):500–507PubMed
6.
7.
go back to reference Feyer PC, Maranzano E, Molassiotis A, Roila F, Clark-Snow RA, Jordan K, et al (2011) Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009. Support Care Cancer 19(Suppl 1):S5–14CrossRefPubMed Feyer PC, Maranzano E, Molassiotis A, Roila F, Clark-Snow RA, Jordan K, et al (2011) Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009. Support Care Cancer 19(Suppl 1):S5–14CrossRefPubMed
8.
go back to reference Maranzano E, De Angelis V, Pergolizzi S, Lupattelli M, Frata P, Spagnesi S, et al (2010) A prospective observational trial on emesis in radiotherapy: analysis of 1020 patients recruited in 45 Italian radiation oncology centres. Radiother Oncol 94(1):36–41CrossRefPubMed Maranzano E, De Angelis V, Pergolizzi S, Lupattelli M, Frata P, Spagnesi S, et al (2010) A prospective observational trial on emesis in radiotherapy: analysis of 1020 patients recruited in 45 Italian radiation oncology centres. Radiother Oncol 94(1):36–41CrossRefPubMed
9.
go back to reference Roila F, Herrstedt J, Gralla RJ, Tonato M (2011) Prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: guideline update and results of the Perugia consensus conference. Support Care Cancer 19(Suppl 1):S63–S65CrossRefPubMed Roila F, Herrstedt J, Gralla RJ, Tonato M (2011) Prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: guideline update and results of the Perugia consensus conference. Support Care Cancer 19(Suppl 1):S63–S65CrossRefPubMed
10.
go back to reference The Italian Group for Antiemetic Research in Radiotherapy (1999) Radiation-induced emesis: a prospective observational multicenter Italian trial. Int J Radiat Oncol Biol Phys 44(3):619–625CrossRef The Italian Group for Antiemetic Research in Radiotherapy (1999) Radiation-induced emesis: a prospective observational multicenter Italian trial. Int J Radiat Oncol Biol Phys 44(3):619–625CrossRef
11.
go back to reference Enblom A, Bergius Axelsson B, Steineck G, Hammar M, Borjeson S (2009) One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient. Support Care Cancer 17(1):23–32CrossRefPubMed Enblom A, Bergius Axelsson B, Steineck G, Hammar M, Borjeson S (2009) One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient. Support Care Cancer 17(1):23–32CrossRefPubMed
12.
go back to reference Poon M, Dennis K, DeAngelis C, Chung H, Stinson J, Zhang L, et al (2014) A prospective study of gastrointestinal radiation therapy-induced nausea and vomiting. Support Care Cancer 22(6):1493–1507CrossRefPubMed Poon M, Dennis K, DeAngelis C, Chung H, Stinson J, Zhang L, et al (2014) A prospective study of gastrointestinal radiation therapy-induced nausea and vomiting. Support Care Cancer 22(6):1493–1507CrossRefPubMed
13.
go back to reference National Cancer Institute of Canada Clinical Trials Group (SC19), Wong RK, Paul N, Ding K, Whitehead M, Brundage M, et al (2006) 5-hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: a placebo-controlled randomized trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). J Clin Oncol 24(21):3458–3464CrossRef National Cancer Institute of Canada Clinical Trials Group (SC19), Wong RK, Paul N, Ding K, Whitehead M, Brundage M, et al (2006) 5-hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: a placebo-controlled randomized trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). J Clin Oncol 24(21):3458–3464CrossRef
14.
go back to reference Flores LT, Bennett AV, Law EB, Hajj C, Griffith MP, Goodman KA (2012) Patient-reported outcomes vs. clinician symptom reporting during chemoradiation for rectal cancer. Gastrointest Cancer Res 5(4):119–124PubMedCentralPubMed Flores LT, Bennett AV, Law EB, Hajj C, Griffith MP, Goodman KA (2012) Patient-reported outcomes vs. clinician symptom reporting during chemoradiation for rectal cancer. Gastrointest Cancer Res 5(4):119–124PubMedCentralPubMed
15.
go back to reference Dennis K, Zhang L, Lutz S, van Baardwijk A, van der Linden Y, Holt T, et al (2012) International patterns of practice in the management of radiation therapy-induced nausea and vomiting. Int J Radiat Oncol Biol Phys 84(1):e49–e60CrossRefPubMed Dennis K, Zhang L, Lutz S, van Baardwijk A, van der Linden Y, Holt T, et al (2012) International patterns of practice in the management of radiation therapy-induced nausea and vomiting. Int J Radiat Oncol Biol Phys 84(1):e49–e60CrossRefPubMed
16.
go back to reference Horiot JC (2004) Prophylaxis versus treatment: is there a better way to manage radiotherapy-induced nausea and vomiting? Int J Radiat Oncol Biol Phys 60(4):1018–1025CrossRefPubMed Horiot JC (2004) Prophylaxis versus treatment: is there a better way to manage radiotherapy-induced nausea and vomiting? Int J Radiat Oncol Biol Phys 60(4):1018–1025CrossRefPubMed
17.
go back to reference Dennis K, Maranzano E, De Angelis C, Holden L, Wong S, Chow E (2011) Radiotherapy-induced nausea and vomiting. Expert Rev Pharmacoecon Outcomes Res 11(6):685–692CrossRefPubMed Dennis K, Maranzano E, De Angelis C, Holden L, Wong S, Chow E (2011) Radiotherapy-induced nausea and vomiting. Expert Rev Pharmacoecon Outcomes Res 11(6):685–692CrossRefPubMed
18.
go back to reference Dennis K, Poon M, Chow E (2015) Nausea and vomiting induced by gastrointestinal radiation therapy; current status and future directions. Dennis K, Poon M, Chow E (2015) Nausea and vomiting induced by gastrointestinal radiation therapy; current status and future directions.
Metadata
Title
A novel prospective descriptive analysis of nausea and vomiting among patients receiving gastrointestinal radiation therapy
Authors
Michael Poon
Jonathan Hwang
Kristopher Dennis
Carlo DeAngelis
Liying Zhang
Hans Chung
Jordan Stinson
Shun Wong
Natalie Pulenzas
Edward Chow
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2942-z

Other articles of this Issue 4/2016

Supportive Care in Cancer 4/2016 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine