title: A prospective study of gastrointestinal radiation therapy-induced nausea and vomiting.
abstract: OBJECTIVE
  Nausea and vomiting are common side effects from radiotherapy that can interfere with gastrointestinal (GI) cancer patients' quality of life (QOL). A prospective study among patients with GI cancers was conducted to document the timing, incidence and risk factors of radiation therapy-induced nausea and vomiting (RINV).
  
  
  METHODS
  Forty-eight patients planned to receive curative or palliative intent abdominal and/or pelvic radiotherapy alone or with concomitant chemoradiotherapy were followed prospectively. All episodes of nausea, vomiting, retching and antiemetic use were recorded daily for the entire treatment period and for the week following completion of therapy. QOL was assessed weekly using the Functional Living Index--Emesis Quality of Life Tool and the EORTC QLQ-C30 core questionnaire.
  
  
  RESULTS
  Nausea occurred in 83 % of patients and emesis in 54 %. Pancreatic cancer was significantly correlated to higher proportions of nausea and emesis (p = 0.002 and p = 0.0003) compared to other primary sites. There were no significant difference between concomitant chemoradiotherapy and radiotherapy only patients for nausea and emesis. Patients had significantly greater proportions of RINV during the first, second and fifth weeks of treatment and during the first week following treatment. Vomiting was found to impair patients' usual recreation or leisure activities and enjoyment of their meals. Worse physical, role and social functioning and greater fatigue and appetite loss over the course of treatment correlated directly with the timing of RINV symptoms.
  
  
  CONCLUSIONS
  RINV worsened QOL and was experienced even after treatment was completed; physicians should therefore be cognizant and monitor patients in the week following radiotherapy. Concomitant chemoradiotherapy should potentially be included in the moderate emetogenic risk category.
authors.affiliation: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Poon
authors.forename: Kristopher
authors.initials: K
authors.lastname: Dennis
authors.forename: Carlo
authors.initials: C
authors.lastname: DeAngelis
authors.forename: Hans
authors.initials: H
authors.lastname: Chung
authors.forename: Jordan
authors.initials: J
authors.lastname: Stinson
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.forename: Gillian
authors.initials: G
authors.lastname: Bedard
authors.forename: Marko
authors.initials: M
authors.lastname: Popovic
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lao
authors.forename: Natalie
authors.initials: N
authors.lastname: Pulenzas
authors.forename: Shun
authors.initials: S
authors.lastname: Wong
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000009:adverse effects; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents