A prospective cohort study of patient-reported vomiting, retching, nausea and antiemetic use during neoadjuvant long-course radiation therapy and concurrent 5-fluorouracil-based chemotherapy for rectal adenocarcinoma
A prospective cohort study of patient-reported vomiting, retching, nausea and antiemetic use during neoadjuvant long-course radiation therapy and concurrent 5-fluorouracil-based chemotherapy for rectal adenocarcinoma
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Background and purpose: Antiemetic guidelines suggest daily prophylaxis with a serotonin3 receptor antagonist (5-HT3RA) as an option for patients receiving long-course neoadjuvant radiation therapy tillman 750m and concurrent 5-fluorouracil-based chemotherapy for rectal cancer, despite the risks that 5-HT3RA-induced constipation may pose.We explored the incidence of patient-reported vomiting, retching, nausea and antiemetic intake among patients in this setting to determine if these risks are justified.Materials and methods: We carried out a single-centre non-randomised prospective cohort study of adult patients receiving long-course neoadjuvant radiation therapy and concurrent 5-fluorouracil-based chemotherapy for rectal adenocarcinoma.Patients recorded symptoms and medication intake daily until 7 days following treatment completion.
Results: From 33 evaluable patients, we remtavares.com collected 1407 days of patient-reported data.Vomiting was reported by 7 patients (21%), retching by 5(15%) and nausea by 21(64%).No patients were administered prophylactic antiemetics.The median number of days with vomiting was 2, and the cumulative number of days for all affected patients was 22 (1.
6% of 1407 evaluable days).There were no differences in PTV or small bowel loop V15Gy, V45Gy and V50Gy volumes between patients that did and did not vomit.Conclusions: The cumulative incidence of days with vomiting was only 1.6%.
5-HT3RA prophylaxis during long-course neoadjuvant treatment seems unnecessary.Keywords: Antiemetic, Nausea, Patient-reported outcome, Radiation therapy, Rectal cancer, Vomiting.