Abstract

STUDY OF THE PATTERN OF ANTIEMETIC USAGE IN CANCER CHEMOTHERAPY INDUCED NAUSEA AND VOMITING

S. A. D.’ Silva, Princy L. Palatty*, Ibel Chiramel Fredy and Suresh Rao

ABSTRACT

Background and Objectives: Cancer chemotherapy induced nausea and vomiting is one of the most common and feared adverse effects in cancer patients, which not only hampers therapy, but also affects the quality of life in these patients. This study investigates patterns of antiemetic regimens, their efficacy, and the effect of chemotherapy induced nausea and vomiting (CINV) on the quality of life of the patients. The objective is to review the antiemetics prescribed in preventing/reducing CINV, to investigate effect of the combination of clinically used standard antiemetic regimens employed in CINV on the quality of life of patients, and to evaluate which antiemetic regimen is more efficacious in CINV. Methods: Around 60 patients were included in the study and were followed up for 6 cycles of chemotherapy. The extent of nausea and vomiting and the effect of the same on the quality of life of the patients were assessed using a modified FLIE questionnaire, which was filled at 0h, 6h, 24h, and 120h following the initiation of chemotherapy. Results: Comparison of the mean of the various parameters showed that the mean age of the patients enrolled was 47.55± 9.893 with 73.3% females and 26.78% males. The most common type of cancer in this study was Ca. breast (35%). Palonosetron was the most common antiemetic used (63.3%), followed by aprepitant, granisetron, and ondansetron. Dexamethasone was prescribed in all patients. Patients who were on antiemetic regimens which didn‟t include aprepitant, complained of acute (75%) and delayed nausea (6%) as well as acute (45%) and delayed emesis (5%). Patients who received aprepitant had complete response (no nausea, no emesis) (100%) The quality of life parameters of patients was not affected significantly. Conclusion: The combination of aprepitant + palonosetron + dexamethasone or aprepitant + dexamethasone were most commonly preferred and achieved reasonable effectiveness that did not compromise their quality of life.

Keywords: Cancer chemotherapy induced nausea and vomiting (CINV), Chemotherapy, Antiemetics, Palonosetron, Aprepitant, Acute and delayed nausea, Acute and delayed emesis.