International Patterns of Practice in the Management of Radiation Therapy-induced Nausea and Vomiting

Journal Article · Sat Sep 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2012.02.031· OSTI ID:22149472

Dennis, Kristopher; Liying, Zhang ^[1]; Lutz, Stephen ^[2]; Baardwijk, Angela van ^[3]; Linden, Yvette van der ^[4]; Holt, Tanya ^[5]; Arnalot, Palmira Foro ^[6]; Lagrange, Jean-Leon ^[7]; Maranzano, Ernesto ^[8]; Liu, Rico ^[9]; Wong, Kam-Hung ^[10]; Wong, Lea-Choung ^[11]; Vassiliou, Vassilios ^[12]; Corn, Benjamin W. ^[13]; De Angelis, Carlo; Holden, Lori; Wong, C. Shun ^[1]; Chow, Edward ^[1]

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1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)
2. Blanchard Valley Health Systems, Findlay, Ohio (United States)
3. Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands)
4. Leiden University Medical Center, Leiden (Netherlands)
5. Radiation Oncology Mater Centre, Princess Alexandra Hospital, Brisbane (Australia)
6. Parc de Salut Mar. Universitat Pompeu Fabra Barcelona (Spain)
7. AP-HP Hopital Henri-Mondor, Universite Paris Est Creteil, Creteil (France)
8. 'S. Maria' Hospital, Terni (Italy)
9. Queen Mary Hospital, Hong Kong (China)
10. Queen Elizabeth Hospital, Hong Kong (Hong Kong)
11. National University Cancer Institute (Singapore)
12. Bank of Cyprus Oncology Centre, Nicosia (Cyprus)
13. Tel Aviv Medical Center, Tel Aviv (Israel)

Purpose: To investigate international patterns of practice in the management of radiation therapy-induced nausea and vomiting (RINV). Methods and Materials: Oncologists prescribing radiation therapy in the United States, Canada, The Netherlands, Australia, New Zealand, Spain, Italy, France, Hong Kong, Singapore, Cyprus, and Israel completed a Web-based survey that was based on 6 radiation therapy-only clinical cases modeled after the minimal-, low-, moderate-, and high-emetic risk levels defined in the antiemetic guidelines of the American Society of Clinical Oncology and the Multinational Association of Supportive Care in Cancer. For each case, respondents estimated the risks of nausea and vomiting separately and committed to an initial management approach. Results: In total, 1022 responses were received. Risk estimates and management decisions for the minimal- and high-risk cases varied little and were in line with guideline standards, whereas those for the low- and moderate-risk cases varied greatly. The most common initial management strategies were as follows: rescue therapy for a minimal-risk case (63% of respondents), 2 low-risk cases (56% and 80%), and 1 moderate-risk case (66%); and prophylactic therapy for a second moderate-risk case (75%) and a high-risk case (95%). The serotonin (5-HT){sub 3} receptor antagonists were the most commonly recommended prophylactic agents. On multivariate analysis, factors predictive of a decision for prophylactic or rescue therapy were risk estimates of nausea and vomiting, awareness of the American Society of Clinical Oncology antiemetic guideline, and European Society for Therapeutic Radiology and Oncology membership. Conclusions: Risk estimates and management strategies for RINV varied, especially for low- and moderate-risk radiation therapy cases. Radiation therapy-induced nausea and vomiting are under-studied treatment sequelae. New observational and translational studies are needed to allow for individual patient risk assessment and to refine antiemetic guideline management recommendations.

• OSTI ID: 22149472
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 84; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
HEALTH HAZARDS
MEDICAL PERSONNEL
MULTIVARIATE ANALYSIS
NAUSEA
NEOPLASMS
PATIENTS
RADIOTHERAPY
RECEPTORS
RECOMMENDATIONS
RISK ASSESSMENT
SEROTONIN
STANDARDS
VOMITING