Pilot study to evaluate control of nausea and vomiting in patients with esophageal cancer (EC) receiving concomitant chemoradiotherapy (cCRT).

Abstract

291 Background: The standard treatment for patients with locally advanced EC is cCRT +/- surgery. Chemotherapy and radiation both attribute to nausea and vomiting and pose significant challenges to patients’ compliance with the treatment. We conducted a pilot study to evaluate their level of control during cCRT. Methods: Weekly surveys were administered during cCRT for first consecutive 5 weeks. Scores scale range was 1-10 to assess nausea and vomiting and related risk factors. Analyses was performed using SPSS v26.0. Wilcoxson test was used to compare medians of pairs and Friedman’s test to compare medians of groups. Results: We had 28 evaluable patients. Majority were males (M=25 vs F=3), median age 64.1 years (range 44-80 yrs.) and ethnicity was Caucasian at 89.29% (n=25). Scores for ‘expect to experience nausea and vomiting’ were below 5 (1=do not expect), medians: 4.00 (SD 2.136), 4.00 (SD 1.939), 3.00 (SD 2.408), 3.50 (SD 2.505) and 4.00 (SD 2.801) for weeks 1 (baseline), 2, 3, 4 and 5, respectively. Significant improvement in the ‘expectation scores’ between weeks 3 and 4 (p=0.022) and baseline to week 5 (p=0.049). Scores for ‘nausea and vomiting control’ vs prior week were also in the lower range (1= better control) indicating good overall control (highest median score 3.00 [SD 2.580] in week 4). ‘Acid reflux episodes’ median scores were on lower range (1=I have episodes very frequently) through all weeks without significant change. On the other hand, ‘acid reflux control’ showed significant improvement in median scores: 2.50 (SD 2.44), 2.00 (SD 2.76), 3.00 (SD 2.40), 2.00 (SD 2.43) and 1.00 (SD 1.81) (p=0.020). ‘Anxiety levels’ scores were highest on baseline (median 3.00 SD 2.299, p=0.022) then deescalated through subsequent weeks (2.00, 1.00, 2.00 & 1.00 at weeks 2, 3, 4 and 5, respectively), p=NS. Conclusions: During cCRT, EC patients demonstrated significant anxiety at baseline, likely due to ‘perceived expectations. Acid reflux control peaks as an important component of treatment strategy for clinicians during cCRT. This suggests that focused control of these symptoms may improve nausea and vomiting control and treatment compliance.