• Title/Summary/Keyword: Chemotherapy induced Nausea & Vomiting

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Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients

  • Shankar, Abhishek;Roy, Shubham;Malik, Abhidha;Julka, PK;Rath, GK
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6207-6213
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    • 2015
  • The supportive care of patients receiving antineoplastic treatment has dramatically improved over the past few years and development of effective measures to prevent nausea and vomiting after chemotherapy serves as one of the most important examples of this progress. A patient who starts cancer treatment with chemotherapy lists chemotherapy-induced nausea and vomiting as among their greatest fears. Inadequately controlled emesis impairs functional activity and quality of life, increases the use of health care resources, and may occasionally compromise adherence to treatment. New insights into the pathophysiology of chemotherapy-induced nausea and vomiting, a better understanding of the risk factors for these effects, and the availability of new antiemetic agents have all contributed to substantial improvements in emetic control. This review focuses on current understanding of chemotherapy-induced nausea and vomiting and the status of pharmacological interventions for their prevention and treatment.

Phase II Study on EANI Combined with Hydrochloride Palonosetron for Prevention of Chemotherapy-induced Nausea and Vomiting Following Highly Emetogenic Chemotherapy

  • Xiao, Yang;Liu, Jun;Liu, Yang-Chen;Huang, Xin-En;Guo, Jian-Xong;Wei, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3951-3954
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    • 2014
  • Objective: To investigate the electronic anti-nausea instrument (EANI) combined with hydrochloride palonosetron for prevention of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. Methods: Patients who received highly emetogenic chemotherapy were randomly assigned to a treatment group (60 patients) treated with EANI combined with hydrochloride palonosetron, and control group (also 60 patients) given only hydrochloride palonosetron. Chemotherapy related nausea and vomiting were observed and recorded in both groups of patients from the start till the end of chemotherapy. Results: Complete control rates of vomiting in treatment and control group were 40%, and 35%, respectively, without any statistical ly significant difference (p>0.05); however the response rates are 95.0%, 78.3%, respectively, with statistical difference (p<0.05). Complete control rates of nausea in treatment and control group were 36.7%, 30%, respectively, without statistical difference (p>0.05); but the response rates are 90.0%, 76.7%, respectively, with statistical difference (p<0.05). Conclusion: EANI combined with hydrochloride palonosetron for prevention of nausea and vomiting induced by chemotherapy could be more effective than hydrochloride palonosetron alone, and can be recommended for use in prevention and treatment of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy.

Effects of Auricular Acupressure on Chemotherapy-induced Nausea, Vomiting, and Serum Serotonin Level (이압요법이 항암화학요법 환자의 오심·구토와 혈청세로토닌 수치에 미치는 효과)

  • Kwon, Soon Jo;Park, Jeong Sook
    • Korean Journal of Adult Nursing
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    • v.26 no.3
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    • pp.330-340
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    • 2014
  • Purpose: The aim of this study was to identify the effects of auricular acupressure on nausea, vomiting and serum serotonin level in gynecological cancer patients with chemotherapy. Methods: The research was a randomized control group pretest-posttest design. Participants were 26 patients for the experimental group, and 26 patients for the control group. Auricular acupressure in Shen men, Occiput, Stomach and Sympathetic points was administered to those in the experimental group. Data were analyzed using ${\chi}^2$-test, t-test, ANCOVA, and repeated measures of ANOVA. Results: The experimental group had reported significantly lower mean nausea NRS (Number Rating Scale), INVR (Index of Nausea, Vomiting, and Retching), and serum serotonin level than those in the control group. Conclusion: Results of the study show auricular acupressure is an effective nursing intervention for reducing chemotherapy-induced nausea, vomiting and serum serotonin level of gynecological cancer patients.

Aprepitant in the Prevention of Vomiting Induced by Moderately and Highly Emetogenic Chemotherapy

  • Wang, Shi-Yong;Yang, Zhen-Jun;Zhang, Zhe;Zhang, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10045-10051
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    • 2015
  • Chemotherapy is a major therapeutic approach for malignant neoplasms; however, due to the most common adverse events of nausea and vomiting, scheduled chemotherapeutic programs may be impeded or even interrupted, which severely impairs the efficacy. Aprepitants, 5-HT3 antagonists and dexamethasone are primary drugs used to prevent chemotherapy-induced nausea and vomiting (CINV). These drugs have excellent efficacy for control of acute vomiting but are relatively ineffective for delayed vomiting. Aprepitant may remedy this deficiency. Substance P was discovered in the 1930s and its association with vomiting was confirmed in the 1950s. This was followed by a period of non-peptide neurokinin-1 (NK-1) receptor antagonist synthesis and investigation in preclinical studies and clinical trials (phases I, II and III). The FDA granted permission for the clinical chemotherapeutic use of aprepitant in 2003. At present, the combined use of aprepitant, 5-HT3 antagonists and dexamethasone satisfactorily controls vomiting but not nausea. Therefore, new therapeutic approaches and drugs are still needed.

Olanzapine for Preventing Nausea and Vomiting Induced by Moderately and Highly Emetogenic Chemotherapy

  • Wang, Shi-Yong;Yang, Zhen-Jun;Zhang, Lu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9587-9592
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    • 2014
  • Nausea and vomiting are common adverse events in chemotherapy. In spite of the serious effects on the quality of life and further treatment, they remain overlooked by physicians, and no standard treatment has been developed. Neurokinin-1 (NK-1) receptor antagonists and palonosetron are the major agents in the standard regimen for treating moderately and highly emetogenic chemotherapy-induced nausea and vomiting (CINV). However, NK-1 receptor antagonists first became commercially available at the end of 2013 and palonosetron has not been extensively applied in China. Olanzapine was recommended as a therapy for moderate and severe CINV in antiemesis-clinical practice guidelines in oncology in 2014 for the first time. It is an atypical antipsychotic agent, which can block multiple receptors on neurotransmitters. During more than 10 years, olanzapine has demonstrated significant effects in preventing CINV and treating breakthrough and refractor CINV, which was observed in case reports, precise retrospective studies, and phase I, II and III clinical trials, with no grade 3 to 4 adverse events. In particular, it is superior to aprepitant and dexamethasone in delayed nausea and vomiting. Therefore, this compound is worthy of further investigation.

Effect of Acupressure on Nausea-vomiting and Weight Change among Pediatric Cancer Patients Receiving Anti-cancer Chemotherapy (지압이 암환아의 오심 구토 정도와 체중변화에 미치는 효과)

  • Kim Tae-Im;Shin Yeong-Hee;Oh Min-Seok
    • Child Health Nursing Research
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    • v.10 no.1
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    • pp.98-107
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    • 2004
  • Purpose: This study was to confirm the effect of acupressure on the emesis control and the weight change among pediatric cancer patients receiving anti-cancer chemotherapy. Method: Forty pediatric cancer patients, receiving the induction stage of chemotherapy with MTX and vincristine, were divided into control(n=20) and the intervention group(n=20). Both groups received regular anti-emesis medication, but the intervention group was added acupressure maneuver for 5 minutes on P6 point for 3 times a day for 5days: before chemotherapy, lunch and dinner by investigator during the hospitalization and by mother at home. The instruments for this study were Rhode's(1986) Index of nausea, vomiting and retching(INVR), Cas electric scale and pamphlet developed by researcher. Result: Significant differences in the degree of nausea and vomiting were observed between the control and the intervention group as measured by INVR(t=4.73; p=.01). Repeated measures ANOVA also shows that the group effect was significant(F=22.39, P=.01) as was the time effect(F=380.35, P=.01). The group by time interaction was also significant(F=5.27, P=.01). Acupressure maneuver was apparently effective in reducing the degree of chemotherapy-induced nausea and vomiting. There were also statistically significant weight loss noted in the control group than the intervention group(t=5.42, p=.01). Conclusion: Acupressure on P6 point shows an effective adjunct maneuver in reducing the degree of nausea and vomiting and conserving the weight in pediatric cancer patients. Therefore, it is proposed that acupressure should be applied as supportive nursing intervention strategies to relieve chemotherapy induced nausea and vomiting and to prevent weight loss in pediatric cancer patients.

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The Meta-Analysis of the Effect of Acupressure for Nausea and Vomiting in Cancer Patients Receiving Chemotherapy (지압이 항암요법환자의 오심과 구토에 미치는 효과 관련 연구 분석)

  • Jang, Soon-Yang;Park, Jeong-Sook
    • Asian Oncology Nursing
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    • v.11 no.2
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    • pp.116-126
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    • 2011
  • Purpose: This study was to analyze the characteristics and effect size of intervention studies that used acupressure for the control of chemotherapy-induced nausea and vomiting (CINV). Methods: Nine electronic databases including Korea Education Research and Information, the National Assembly Library, KISS, Korea Med, NDSL, PubMed, EBSCO, Cochrane library, and OVID (to December, 2009) were searched. Thirteen studies of randomized controlled trials (RCTs) or controlled clinical trials (CCTs) were selected. Data were analyzed by SPSS/WIN 18.0. Results: Overall effect size of acupressure was moderate (0.684). Nausea had a moderate effect size (0.770) and nausea and vomiting had a high effect size (0.899). Acupressure using sticker needles had a high effect size (1.368) among finger acupressure, si-acupuncture, and wrist band treatment. Conclusion: This study suggests that acupressure using sticker needles on the spots of nei-guan, chok-samni and hap-kok can reduce the levels of nausea and vomiting in cancer patients receiving chemotherapy. For improving the reliability of the meta-analysis results, further randomized controlled trials with better study methodology are needed.

A Clinical Study on Two Cases of Chemotherapy Induced Nausea and Vomiting (CINV) and Radiotherapy Induced Nausea and Vomiting (RINV) Patients Treated by Gamihachul-Tang-Gagam-bang (加味夏朮湯加減方의 항암 및 방사선 치료 후 오심증상 개선에 대한 임상 2례)

  • Pak, Yeon-Kyoung;Park, Kang-In;Park, Kyoung-Sun;Hwang, Deok-Sang;Lee, Chang-Hoon;Jang, Jun-Bock;Lee, Jin-Moo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.3
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    • pp.97-106
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    • 2015
  • Objectives The purpose of this study is to report the effect of Gamihachul-tang-gagam-bang on two patients with Chemotherapy Induced Nausea and Vomiting (CINV) and Radiotherapy Induced Nausea and Vomiting (RINV). respectively. Methods Two patients with CINV and RINV who admitted KyungHee University Hospital at Gangdong were treated by oriental medical treatments such as acupuncture, moxibustion, cupping treatment and herbal medicine ( Gamihachul-tang-gagam-bang ). Results After treatments, patients' nausea and vomiting improved and patients' amount of intake also increased. Conclusions According to this case report, Gamihachul-tang-gagam-bang is effective for treating CINV and RINV.

Compliance with the Protocol Considered Emetogenic Potential for Prophylaxis of Chemotherapy Induced Nausea and Vomiting (항암화학요법의 구토유발 수준별 예방적 항구토제 프로토콜의 이행정도)

  • Choi, Ja-Yun;Oh, Hyeon-Jeong;Kang, Ji-Young;Kim, Min-Kyoung;Kim, Ji-Eun;Kim, Jin-Ha;Kim, Hee-Suk;Park, So-Ra;Byun, Jeong-Seon;An, Jeong-Hee;Cho, Min-Kyoung
    • Asian Oncology Nursing
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    • v.11 no.1
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    • pp.58-64
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    • 2011
  • Purpose: The purpose of this study was to identify the compliance with the protocol, which was developed considering the emetogenic potential for prophylaxis of chemotherapy. Methods: Data was collected from 144 patients who received chemotherapy from June 15 to August 31, 2010 in C University Hospital in Jeollanamdo, Korea. The level of chemotherapy-induced nausea and vomiting (CINV) and the compliance with the protocol for prophylaxis of CINV were measured. Results: There was statistically significant difference of CINV in morning sickness and anticipatory nausea of general and clinical characteristics. Also, the compliance with the protocol developed according to emetogenic potential of chemotherapy was statistically significant. There was no difference in CINV in regard to the compliance with the protocol. Conclusion: There was a good compliance with the protocol for prophylaxis according to emetogenic potential. But it should be recommended to use antiemetics for prophylaxis aggressively to relieve CINV for the patients who already experienced morning sickness and anticipatory nausea. In addition, the oncology nurses should respond sensitively to the complaints of nausea and vomiting no matter what the emetogenic potentials of chemotherapy regimen are.

Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy

  • Ansari, Mansour;Porouhan, Pezhman;Mohammadianpanah, Mohammad;Omidvari, Shapour;Mosalaei, Ahmad;Ahmadloo, Niloofar;Nasrollahi, Hamid;Hamedi, Seyed Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3877-3880
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    • 2016
  • Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the first 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (${\pm}1.31$) and 1.46 (${\pm}1.28$) with no statistically significant difference. After the $2^{nd}$ chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After $3^{rd}$ chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (${\pm}1.14$), versus 1.42 (${\pm}1.30$)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (${\pm}0.96$) and in control arm it was 1.40 (${\pm}0.92$). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (${\pm}1.03$), 0.68 (${\pm}1.00$) and 0.77 (${\pm}1.18$). In control arm, mean vomiting was 0.983 (${\pm}1.23$), 1.03 (${\pm}1.22$) and 1.15 (${\pm}1.27$). In all sessions, ginger decreased vomiting severity from 1.4 (${\pm}1.04$) to 0.71 (${\pm}0.86$). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe ($0.64{\pm}0.87$) comparing to those who received placebo ($1.13{\pm}1.12$), which was statistically significant (p-Value <0.05). Further and larger studies are needed to draw conclusions.