How to improve the prevention of chemotherapy-induced nausea and vomiting? The French NAVI study.
OBJECTIVE
Chemotherapy-induced nausea and vomiting (CINV) still remain frequent. The procedure for announcing the diagnosis (PAD) was an emblematic measure of the first French Plan Cancer aiming at providing patients with time to listen, information after cancer diagnosis, and discussion on treatments and their side effects. We aimed at assessing the risk factors of CINV, focusing on patients' satisfaction with the PAD.


METHODS
This prospective multicentre study assessed the frequency and intensity of CINV among chemonaïve patients during the first cycle of treatment. CINV was defined by ≥1 emetic episode or reported nausea intensity ≥3 on a 0-10 scale. Multivariate analysis was used to identify factors related to global CINV onset including satisfaction with the PAD (satisfaction score ≥the median on a 0-10 scale).


RESULTS
Data from 291 patients (women, 85.2%; mean age, 57 years) were analyzed. Most patients (69.4%) received highly emetogenic chemotherapy regimens and 77.7% received antiemetic drugs consistent with international guidelines. Acute, delayed and overall CINV were experienced by 40.4, 34.8 and 52.4% of patients, respectively. Sixty-seven per cent of patients were satisfied with the PAD. No relation was noted between PAD satisfaction and CINV onset. The nausea and vomiting dimension of the QLQ-C30 questionnaire before chemotherapy (OR 3.62), motion sickness history (OR 2.73), highly emetogenic CT (OR 2.73), anxiety (OR 1.99) and younger age (OR 1.96) were independent predictive factors.


CONCLUSIONS
Although patients were mostly satisfied with the PAD, half of them experienced CINV. A state of anxiety could be identified during the PAD to be managed.
Centre François Baclesse, Department of Oncology, Caen, France.
Julie
J
Vanbockstael
Centre François Baclesse, Department of Oncology, Caen, France. e.coquan@baclesse.unicancer.fr.|Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France. e.coquan@baclesse.unicancer.fr.
Elodie
E
Coquan
Rouen University Hospital, Department of Oncology, Rouen, France.|Centre Henri Becquerel, Department of Oncology, Rouen, France.
Sophie
S
Gouerant
Centre François Baclesse, Department of Oncology, Caen, France.
Djelila
D
Allouache
Centre François Baclesse, Department of Oncology, Caen, France.
Audrey
A
Faveyrial
Centre François Baclesse, Department of Oncology, Caen, France.
Sabine
S
Noal
Centre François Baclesse, Department of Oncology, Caen, France.
Corinne
C
Delcambre
Centre François Baclesse, Department of Oncology, Caen, France.
Marie-Pierre
MP
Galais
Centre François Baclesse, Department of Oncology, Caen, France.
Jean-François
JF
Héron
Centre François Baclesse, Department of Oncology, Caen, France.
Anne-Charlotte
AC
Lefebvre
Centre François Baclesse, Department of Oncology, Caen, France.
Emmanuel
E
Sevin
Centre François Baclesse, Department of Oncology, Caen, France.
Ioana
I
Hrab
Centre François Baclesse, Department of Oncology, Caen, France.
Florence
F
Polycarpe
Hôpital Monod, Department of Oncology, Flers, France.
Michel
M
André
Centre Hospitalier Public du Cotentin, Department of Oncology, Cherbourg-Octeville, France.
Laure
L
Kaluzinski
Centre François Baclesse, Department of Oncology, Caen, France.
Radj
R
Gervais
Centre François Baclesse, Department of Oncology, Caen, France.
Katharina
K
Gunzer
Clinique Armoricaine, Department of Oncology, Saint-Brieuc, France.
Brigitte
B
Vié
Hôpital Monod, Department of Oncology, Flers, France.
Gilles
G
Saucier
Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.
Noëmie
N
Lemenand
Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.
Jean-Michel
JM
Grellard
Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.
Bénédicte
B
Clarisse
Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.
Audrey Emmanuelle
AE
Dugué
Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.|Université de Caen Basse-Normandie, UMR-S1077, Caen, France.|INSERM, U1086, Caen, France.|CHU de Caen, Department of Oncology, Caen, France.
Florence
F
Joly
D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D011446:Prospective Studies; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D000932:Antiemetics; D000970:Antineoplastic Agents
Cancer announcement; Chemotherapy-induced nausea and vomiting; Nausea; Vomiting