title: Chemotherapy-induced nausea and vomiting is less controlled at delayed phase in patients with esophageal cancer: a prospective registration study by the CINV Study Group of Japan.
abstract: Chemotherapy is an indispensable therapeutic approach for esophageal cancer. Although chemotherapy-induced nausea and vomiting (CINV) is one of the most crucial adverse events, the current state of CINV in patients with esophageal cancer remains unclear. This multicenter prospective observational study analyzed data for 192 patents with esophageal cancer who underwent moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC). The patients recorded their CINV incidence and severity daily for 7 days after receiving chemotherapy, using visual analog scales (VAS). Of the 192 patients, 181 received HEC including cisplatin, and 11 patients received MEC including nedaplatin. Approximately 81% of HEC and 82% of MEC patients received antiemetic therapy in compliance with guidelines. Although CINV was controlled relatively well in the early phase (days 1-4), it was not fully controlled in late phase (days 5-7) for both the HEC and MEC groups. Female sex was a major risk factor for delayed vomiting (P=0.034). Multivariate logistic regression analysis for VAS revealed that motion sickness, age, and use of other antiemetics were risk factors for delayed nausea. Adherence to antiemetic guidelines effectively controls vomiting but is less effective against delayed CINV in both HEC and MEC patients. Identification of individual risk factors, such as female sex, will help develop personalized treatments for CINV. In the clinical setting for esophageal cancer, regimens that include nedaplatin might need to be treated as HEC.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Chuo-ku, Kumamoto, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Baba
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Chuo-ku, Kumamoto, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.affiliation: Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Osaka, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, School of Medicine, Toho University, Ota-ku, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimada
authors.affiliation: Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Shibata
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Asahi-ku, Yokohama, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Department of Esophagogastric Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Nakajima
authors.affiliation: Department of Medical Oncology, KKR Sapporo Medical Center Tonan Hospital, Chu-ou-ku, Sapporo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tsuji
authors.affiliation: Department of Cancer Information Research, National Hospital Organization Kyushu Cancer Center, Mimami-ku, Fukuoka, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Shimokawa
authors.affiliation: Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.affiliation: Department of Internal Medicine, Division of Clinical Oncology and Hematology, The Tokyo Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aiba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009325:Nausea / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology; D009944:Organoplatinum Compounds / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; C053989:nedaplatin; D002945:Cisplatin
keywords: CINV; antiemetic guidelines; antiemetics; chemotherapy; esophageal cancer