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Tytuł:
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A prospective audit on the use of prophylactic antiemetics and rates of CINV in patients receiving carboplatin AUC≥4 or combination anthracycline-cyclophosphamide.
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Autorzy:
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Lo E; Phase 1/Lung Research Fellow, Auckland Cancer Trials Centre, Auckland District Health Board.
Anderson M; Regional Cancer Treatment Service, MidCentral District Health Board.
Carroll R; Regional Cancer Treatment Service, MidCentral District Health Board.
Forgeson G; Regional Cancer Treatment Service, MidCentral District Health Board.
Isaacs R; Regional Cancer Treatment Service, MidCentral District Health Board.
Jordan J; Regional Cancer Treatment Service, Hawke's Bay District Health Board.
Satterthwaite L; Regional Cancer Treatment Service, MidCentral District Health Board.
Wewala N; Regional Cancer Treatment Service, MidCentral District Health Board.
Fernando J; Regional Cancer Treatment Service, MidCentral District Health Board.
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Źródło:
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The New Zealand medical journal [N Z Med J] 2021 Apr 16; Vol. 134 (1533), pp. 33-45. Date of Electronic Publication: 2021 Apr 16.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2022- : Auckland : Pasifika Medical Association Group
Original Publication: Wellington : New Zealand Medical Association
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MeSH Terms:
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Anthracyclines/*adverse effects
Antiemetics/*therapeutic use
Antineoplastic Combined Chemotherapy Protocols/*adverse effects
Carboplatin/*adverse effects
Cyclophosphamide/*adverse effects
Nausea/*prevention & control
Vomiting/*prevention & control
Adult ; Aged ; Aged, 80 and over ; Anthracyclines/pharmacokinetics ; Antineoplastic Combined Chemotherapy Protocols/pharmacokinetics ; Area Under Curve ; Carboplatin/pharmacokinetics ; Cyclophosphamide/pharmacokinetics ; Female ; Humans ; Male ; Medical Audit ; Middle Aged ; Prospective Studies
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Substance Nomenclature:
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0 (Anthracyclines)
0 (Antiemetics)
8N3DW7272P (Cyclophosphamide)
BG3F62OND5 (Carboplatin)
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Entry Date(s):
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Date Created: 20210430 Date Completed: 20210519 Latest Revision: 20210519
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Update Code:
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20240104
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PMID:
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33927422
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Background: Chemotherapy-induced nausea and vomiting (CINV) are two of the most frequently experienced and distressing side effects of cancer treatment. Recent updates by ESMO/MASCC and ASCO on guidelines for prevention of CINV have recommended the addition of a neurokinin-1 receptor antagonist to antiemetic regimens for patients receiving carboplatin-based chemotherapy area under the curve (AUC) ≥4 mg/mL per minute, and an addition of olanzapine for those receiving combination anthracycline/cyclophosphamide chemotherapy.
Aims: To assess current use of prophylactic antiemetics and rates of CINV in patients under the care of MidCentral Regional Cancer Treatment Service (MRCTS) receiving carboplatin AUC≥4 or combination anthracycline/cyclophosphamide.
Methods: Data was prospectively collected on patients under the care of MRCTS receiving carboplatin AUC≥4 or combination anthracycline/cyclophosphamide chemotherapy, including breast cancer patients receiving 5-fluorouracil, epirubicin and cyclophosphamide (FEC) and lymphoma patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). Questionnaires were given to eligible patients to be completed daily from day two to day six of first cycle of chemotherapy only. Data on each patient's gender, age, types of chemotherapies, types of malignancies, presence of nausea or vomiting, number of dry retching or vomiting episodes and anti-emetics were recorded.
Results: From 15 September 2018 to 10 August 2019, a total of 44 patients receiving carboplatin-based chemotherapy AUC≥4 and 30 patients receiving combination anthracycline/cyclophosphamide were included. Twenty-two patients (50%) had either emesis or significant nausea in the overall and delayed phase when treated with carboplatin AUC≥4, and only three (7%) in the acute phase. Fourteen patients (56%) had either emesis or significant nausea in the overall phase when treated with FEC chemotherapy, mostly in the acute phase (13 patients) rather than in the delayed phase (9 patients).
Conclusion: The rates of CINV are high with the existing antiemetic regimens used at MidCentral Regional Cancer Treatment Service. Therefore, in accordance with international guidelines, we will add a neurokinin-1 antagonist to the antiemetic regimens for patients receiving carboplatin-based chemotherapy AUC≥4, and olanzapine for those receiving combination anthracycline/cyclophosphamide chemotherapy, in an attempt to improve the rates of CINV in these groups. Repeating this audit post-implementation of above recommendations will be important to assess for any improvement.
Competing Interests: Nil.