Prevention of chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients receiving adjuvant chemotherapy: Single institution experience

Abstract

Introduction. The modern treatment of malignant diseases and the use of antineoplastic agents pose numerous challenges in terms of the side effects from applied specific oncological treatment. Despite to the significant progress in recent years, emesis and nausea are the two most common and most stressful side effects of cancer treatment and their successful management is still a great challenge. Chemotherapy-induced vomiting or nausea (CINV) significantly affects the quality of life of patients, can cause metabolic disorders, diarrhea, eating disorders and general physical and mental disorders and can question the further anti-tumor treatment of the patient. The prevention and the treatment of CINV and antiemetic therapy have central role in modern protocols for oncological treatment of malignant diseases, including breast cancer patients. Aim. The aim of our study was to obtain data about the efficacy of antiemetic prophylaxis in patients with breast cancer who received chemotherapy following the EC75 protocol in adjuvant setting and the compliance of the patients for the both acute and delayed emesis and nausea. Materials and methods. A prospective study was conducted in 32 breast cancer patients receiving chemotherapy following an EC75 protocol in an adjuvant setting for four consecutive chemotherapy cycles between February 2015 and June 2015. All patients received adequate premedication on day 1 prior to chemotherapy and appropriate oral postmedication was recommended in day 2-5 (with 5-HT3 antagonist and corticosteroid). The occurrence of acute and delayed nausea and emesis as well as taking the recommended postmedicaton by patients was evaluated through a specially structured questionnaire that beside general information contained the following information: the appearance of emesis and nausea within 24 hours after receiving chemotherapy and within the next 10 days, taking the recommended postmedication and the number of taken tablets and taking additional therapy besides the recommended. Results. Out of 32 patients, acute onset of nausea, nausea till day 5 and nausea from 5 to 10 day was recorded in 50%, 44% and 31% of patients, respectively. The results of the occurrence of acute emesis, emesis to to day 5 and nausea from 5 to 10 day were 16%, 9% and 0% respectively. Patients who received complete postmedication have reported acute nausea, nausea till day 5 and nausea from 5 to 10 day in 50%, 50% and 20%, while in patients with partial postmedication 50%, 59% and 39%, respectively. Conclusion. The obtained results do not indicate that acute and delayed nausea are more difficult to control. In patients’ good compliance, better control of both acute and postponed emesis is achieved, although the results obtained in patients with partial compliance may be due to failure to follow the recommended treatment. Despite the effectiveness of antiemetic prophylaxis and good compliance, there is a possibility for its improvement with introduction of new generations of antiemetics. Keywords: Chemotherapy, emesis, nausea, breast cancer, compliance