title: A prospective observational study on chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer by the CINV Study Group of Japan.
abstract: OBJECTIVE
  This study was performed to investigate the occurrence of and risk factors for chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer.
  
  
  METHODS
  In total, 214 patients with gynecologic cancer who underwent highly emetogenic (HEC) or moderately emetogenic chemotherapy (MEC) were evaluated. We investigated the relationship between CINV and clinical factors and the accuracy of estimation of CINV by medical staff in the acute and late phases. Vomiting was evaluated in terms of frequency, and nausea was evaluated with a 100-mm visual analog scale on days 1 to 7. We also analyzed the risk factors and changes in CINV over time using a generalized linear mixed (GLM) model.
  
  
  RESULTS
  The multivariate analysis revealed no significant risk factors for acute CINV. The independent risk factors for delayed nausea were a morning sickness history (odds ratio [OR], 2.687; 95% confidence interval [95% CI], 1.450-4.976; p=0.0017), age (each 1-year increment) (OR, 0.97; 95% CI, 0.944-0.996; p=0.0235), and HEC (OR, 2.134; 95% CI, 1.039-4.383; p=0.0391). The GLM model demonstrated that the independent factors affecting nausea were significant morning sickness (p=0.0101) and HEC (p=0.0136). These data also showed more severe nausea from days 3 to 5, but the negative predictive value for estimation of delayed nausea by medical staff was 57.8%.
  
  
  CONCLUSIONS
  Our data suggest that improvement of preventive antiemetic administration is needed for patients with risk factors to manage delayed CINV caused by HEC and by MEC.
authors.affiliation: Nagoya University Graduate School of Medicine, Japan. Electronic address: mmizuno@aichi-cc.jp.
authors.forename: Mika
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: National Hospital Organization Shikoku Cancer Center, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Hiura
authors.affiliation: Nagoya University Graduate School of Medicine, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
authors.affiliation: Tokuyama Central Hospital, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Numa
authors.affiliation: Tohoku University Graduate School of Medicine, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
authors.affiliation: Faculty of Medicine, Oita University, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Narahara
authors.affiliation: Keio University School of Medicine, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
authors.affiliation: Kousei General Hospital, Japan.
authors.forename: Eizo
authors.initials: E
authors.lastname: Kimura
authors.affiliation: Kanagawa Cancer Center, Japan.
authors.forename: Hisamori
authors.initials: H
authors.lastname: Kato
authors.affiliation: National Hospital Organization Kyushu Cancer Center, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Shimokawa
authors.affiliation: Iwate Medical University, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Sugiyama
authors.affiliation: Kurume University School of Medicine, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Kamura
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D004639:Emetics; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006176:Gynecology; D006801:Humans; D007564:Japan; D016014:Linear Models; D008875:Middle Aged; D048968:Morning Sickness / Q000453:epidemiology; D009325:Nausea / Q000139:chemically induced* / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D064232:Visual Analog Scale; D014839:Vomiting / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents; D004639:Emetics
keywords: Antiemetics; Chemotherapy; Gynecologic cancer; Nausea; Vomiting