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Acute and delayed nausea and emesis control in pediatric oncology patients
Article first published online: 10 JAN 2006
Copyright © 2006 American Cancer Society
Volume 106, Issue 4, pages 931–940, 15 February 2006
How to Cite
Holdsworth, M. T., Raisch, D. W. and Frost, J. (2006), Acute and delayed nausea and emesis control in pediatric oncology patients. Cancer, 106: 931–940. doi: 10.1002/cncr.21631
- Issue published online: 3 FEB 2006
- Article first published online: 10 JAN 2006
- Manuscript Accepted: 23 AUG 2005
- Manuscript Revised: 19 AUG 2005
- Manuscript Received: 15 MAR 2005
To the authors' knowledge there is little information available regarding the effectiveness of standard antiemetic therapy among cancer patients who receive emetogenic chemotherapy in clinical practice, especially in the pediatric population. The current study was undertaken to determine the effectiveness of standard antiemetic interventions among children receiving emetogenic chemotherapy.
The authors conducted a retrospective review of antiemetic surveys for children who received emetogenic chemotherapy. Patients and/or their parents were surveyed for acute and delayed nausea and emesis after each course of emetogenic chemotherapy. The survey consisted of validated measures of the severity of nausea and emesis. Complete protection (CP) rates were calculated for each chemotherapy regimen during both the acute and delayed phases and also by gender and age group (ages birth–3 yrs, 4–11 yrs, and 12–20 yrs). Antiemetic therapy consisted of intravenous ondansetron administered once daily during chemotherapy either alone (for moderately emetogenic chemotherapy) or in combination with dexamethasone (for severely emetogenic chemotherapy).
In total, 224 different patients completed 1256 surveys. CP from both acute and delayed nausea and emesis was more likely in the children ages birth–3 years than in older children. For moderately emetogenic regimens, nausea and emesis in the acute and delayed phases were controlled well. Among severely emetogenic chemotherapy regimens, 7 of 12 different regimen types had CP rates < 50% in either the acute phase or the delayed phase. CP rates were particularly low for cisplatin-based and cyclophosphamide-based regimens.
Nausea and emesis remain significant problems among children who receive emetogenic chemotherapy. CP rates were associated significantly with patient age, and higher rates were observed among very young children. Cancer 2006. © 2006 American Cancer Society.