title: Prophylaxis of radiotherapy-induced nausea and vomiting in the palliative treatment of bone metastases.
abstract: OBJECTIVE
  To document the incidence and timing of radiotherapy-induced nausea and vomiting (RINV) in the treatment of bone metastases among patients receiving prophylaxis with a 5-HT(3) receptor antagonist.
  
  
  METHODS
  Patients receiving single (SF) or multiple fraction (MF) palliative radiotherapy (RT) of moderate or low emetogenic risk for bone metastases were prescribed prophylactic Ondansetron. The frequency and duration of prophylaxis and the use of rescue antiemetics were left to the discretion of the treating physicians. Patients documented episodes of nausea (N) and vomiting (V) in daily diaries before and during RT, and until 10 days following RT completion. Rates of complete prophylaxis (CP) for N&V, respectively (CP = no event and no rescue medication), were calculated for the acute phase (the period from the start of RT to the first day following RT completion inclusive) and the delayed phase (the second to tenth days following RT completion inclusive).
  
  
  RESULTS
  Fifty-nine patients were enrolled, and 32 were evaluable. CP rates were as follows: moderate-risk SF group (n = 16), acute phase (CP for N = 56%, CP for V = 69%) and delayed phase (CP for N = 31%, CP for V = 44%); moderate-risk MF group (n = 7), acute phase (CP for N = 71%, CP for V = 57%) and delayed phase (CP for N = 43%, CP for V = 57%); low-risk SF group (n = 8), acute phase (CP for N = 50%, CP for V = 100%) and delayed phase (CP for N = 43%, CP for V = 57%); and low-risk MF group (n = 1), acute phase (CP for N = 100%, CP for V = 100%) and delayed phase (CP for N = 100%, CP for V = 100%).
  
  
  CONCLUSIONS
  Despite prophylaxis, RINV was common among patients receiving palliative radiotherapy for bone metastases, especially during the delayed phase.
authors: Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors: Kristopher
authors: K
authors: Dennis
authors: Janet
authors: J
authors: Nguyen
authors: Roseanna
authors: R
authors: Presutti
authors: Carlo
authors: C
authors: DeAngelis
authors: May
authors: M
authors: Tsao
authors: Cyril
authors: C
authors: Danjoux
authors: Elizabeth
authors: E
authors: Barnes
authors: Arjun
authors: A
authors: Sahgal
authors: Lori
authors: L
authors: Holden
authors: Florencia
authors: F
authors: Jon
authors: Shun
authors: S
authors: Wong
authors: Edward
authors: E
authors: Chow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control*; D017294:Ondansetron / Q000627:therapeutic use*; D010166:Palliative Care; D016896:Treatment Outcome; D014839:Vomiting / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D017294:Ondansetron