Incidence of chemotherapy-induced nausea and vomiting in Taiwan: Perception versus reality

Abstract

8200 Background: We aimed to determine the incidence of acute and delayed chemotherapy-induced nausea and vomiting (CINV) among patients receiving chemotherapy (CTx) and to assess the accuracy with which medical providers perceive the prevalence of CINV among their patients. Methods: Medical providers from 2 cancer centers in Taiwan estimated the incidence of acute (24 hrs post CTx) and delayed (days 2–5 post CTx) nausea (N) and vomiting (V) after CTx. CTx-naïve patients from the same centers completed a 5-day N/V diary following highly and moderately emetogenic chemotherapy (HEC and MEC) to report the actual incidence of acute and delayed N/V. Daily N ratings were recorded on a 100-mm visual analogue scale (VAS). No N was defined as a VAS score < 5 mm. Vomiting episodes were recorded. Complete response was defined as no V and no rescue therapy. Results: 37 medical providers (13 specialists, 4 residents, 20 nurses) and 107 patients enrolled. Mean patient age was 49.2 years; 76% female; 74% breast cancer; 39% received HEC and 61% MEC; 77% received a 5-HT3 receptor antagonist and 94% dexamethasone. There was no significant difference between patients with and without acute CINV with respect to demographic characteristics, and CTx and antiemetic treatments. Good control of N/V during the acute phase was correlated with good control in the delayed phase. Medical providers predicted acute N/V and delayed N/V in 44%/41% and 61%/53% of HEC patients, respectively, while patient diaries reported acute N/V and delayed N/V in 43%/21% and 64%/60% of HEC patients, respectively. For MEC patients, medical providers predicted acute N/V and delayed N/V in 39%/36% and 44%/39% of patients, respectively, while patient diaries reported acute N/V and delayed N/V in 55%/18% and 74%/55% of patients, respectively. Conclusions: The incidence of acute vomiting caused by HEC or MEC is overestimated by medical providers. However, the incidence of delayed N/V caused by MEC appears to be underestimated by medical providers. The success of symptomatic control should not be assumed but should be established through assessment with the help of the patient. No significant financial relationships to disclose.