Vomiting In Breast Cancer Patients Research Articles

Prevalence of anticipatory nausea and vomiting in breast cancer patients undergoing highly emetogenic chemotherapy.

Anticipatory nausea and vomiting are unpleasant symptoms observed before undergoing chemotherapy sessions. Less is known about the occurrence of symptoms since the advent of the new neurokinin-1 antagonist. This prospective cohort study was performed at a single Brazilian Institution. This study included breast cancer patients who received doxorubicin and cyclophosphamide chemotherapy and an appropriate antiemetic regimen (dexamethasone 10 mg, palonosetron 0.56 mg, and netupitant 300 mg in the D1 followed by dexamethasone 10 mg 12/12 h in D2 and D4). Patients used a diary to record nausea, vomiting, and use of rescue medication in the first two cycles of treatment. The prevalence of anticipatory nausea and vomiting was assessed before chemotherapy on day 1 of C2. From August 4, 2020, to August 12, 2021, 60 patients were screened, and 52 patients were enrolled. The mean age was 50.8 (28-69) years, most had stage III (53.8%), and most received chemotherapy with curative intent (94%). During the first cycle, the frequency of overall nausea and vomiting was 67.31%, and that of severe nausea and vomiting (defined as grade>4 on a 10-point visual scale or use of rescue medication) was 55.77%. Ten patients had anticipatory nausea and vomiting (19.23%). The occurrence of nausea and vomiting during C1 was the only statistically significant predictor of anticipatory nausea and vomiting (OR=16, 95%CI 2.4-670.9, p=0.0003). The prevalence of anticipatory nausea is still high in the era of neurokinin-1 antagonists, and failure of antiemetic control in C1 remains the main risk factor. All efforts should be made to control chemotherapy-induced nausea or nausea and vomiting on C1 to avoid anticipatory nausea.

32P Efficacy of olanzapine in the prophylaxis of delayed chemotherapy-induced nausea and vomiting in breast cancer patients receiving dose-dense AC with a steroid-sparing regimen: A single-center pilot study

32P Efficacy of olanzapine in the prophylaxis of delayed chemotherapy-induced nausea and vomiting in breast cancer patients receiving dose-dense AC with a steroid-sparing regimen: A single-center pilot study

Oral Care With Evidence of Nausea and Vomiting In Breast Cancer Patients Treating Chemotherapy

This study was to determine the relationship between oral care and the incidence of nausea and vomiting in breast cancer patients undergoing chemotherapy. This research method uses descriptive correlation by using a cross sectional approach. The sample of this study was breast cancer patients who underwent chemotherapy as many as 34 respondents using accidental sampling technique. The results of the univariate analysis of this study with oral care in the poor category as many as 29 respondents (82.9%) and nausea and vomiting in the poor category as many as 27 respondents (77.1%) in breast cancer patients undergoing chemotherapy. The results of this study found a relationship between oral care and nausea and vomiting in breast cancer patients undergoing chemotherapy with a value (p = 0.000 < = 0.05). In conclusion, the treatment is able to monitor the management of nausea and vomiting due to chemotherapy, the patient's response before, during and after chemotherapy, as well as assessing the effectiveness of oral care actions carried out by patients and their families

Mouth Treatment with The Incidence of Nau, Vogting In Breast Cancer Patients Undergoing Chemotherapy

This study was to determine the relationship between oral care and the incidence of nausea and vomiting in breast cancer patients undergoing chemotherapy. This research method uses descriptive correlation by using a cross sectional approach. The sample of this study was breast cancer patients who underwent chemotherapy as many as 34 respondents using accidental sampling technique. The results of the univariate analysis of this study with oral care in the poor category as many as 29 respondents (82.9%) and nausea and vomiting in the poor category as many as 27 respondents (77.1%) in breast cancer patients undergoing chemotherapy. The results of this study found a relationship between oral care and nausea and vomiting in breast cancer patients undergoing chemotherapy with a value (p = 0.000 < = 0.05). In conclusion, the treatment is able to monitor the management of nausea and vomiting due to chemotherapy, the patient's response before, during and after chemotherapy, as well as assessing the effectiveness of oral care actions carried out by patients and their families

Determining the Effect of Reflexology on Nausea, Vomiting and Anxiety in Patients with Breast Cancer Receiving Chemotherapy: A Randomized Controlled Study

Aim: This study was conducted in a randomized controlled manner to evaluate the effect of reflexology on nausea, vomiting, and anxiety due to taxane group chemotherapeutics in patients with breast cancer. Method: The study was conducted in the Daytime Chemotherapy Unit of Gülhane Training and Research Hospital and Ankara Training and Research Hospital from June 28 to December 20, 2019, with intervention (n = 29) and control (n = 29) groups. Data were collected using the Patient Information Form, the Rhodes Index of Nausea, Vomiting and Retching, and the Spielberger State-Trait Anxiety Inventory. Patients in the intervention group received reflexology for a total of 6 weeks, once a week. The patients in the control group did not receive any treatment other than the routine maintenance of the chemotherapy unit. Result: As a result, it was determined that 40% of all patients were 55 years or older. While nausea was observed in all patients in the intervention and control groups, vomiting was not noted in the vast majority of patients. Regarding the effect of reflexology on nausea and vomiting, although the mean scores of nausea, vomiting and retching experience, occurrence and distress in both groups were lower than the initial measurement, there was no difference between the groups. Based on the research findings, the State and Trait Anxiety mean scores in the intervention group decreased significantly, while they increased in the control group. Conclusion: The research showed that while reflexology did not affect nausea and vomiting in breast cancer patients receiving chemotherapy, it was helpful in reducing anxiety.

Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial

BackgroundAuricular acupressure (AA) has been viewed as a promising approach to managing chemotherapy-induced nausea and vomiting (CINV) but relevant research evidence has been inconclusive. This study aimed to examine the effects of AA on CINV in breast cancer (BC) patients undergoing chemotherapy.MethodsA preliminary randomized controlled trial was conducted in 114 BC patients. Participants were randomly allocated to a true AA group (n = 38), a sham AA group (n = 38), and a standard care group (n = 38). All the participants were provided with standard antiemetic treatment and care, while the true AA group and the sham AA group received an additional 5-day true AA and a 5-day sham AA, respectively. Acute and delayed CINV were assessed by using the MASCC Antiemesis Tool (MAT), anticipatory nausea and vomiting were measured by the Index of Nausea, Vomiting, and Retching (INVR), and patients’ quality of life (QoL) was evaluated by the Functional Assessment of Cancer Therapy-Breast (FACT-B).ResultsBoth the true and sham AA groups reported improved CINV outcomes than the standard care group, with the true AA demonstrating larger effects than the sham comparison. The true and sham AA groups had higher complete response (CR) rates of CINV when compared with the standard care group, with the difference in the CR of acute CINV achieving statistical significance (p = 0.03). Both the true and sham AA groups demonstrated lower incidence and severity of acute CINV compared with the standard care group with the among-group difference reaching statistical significance for the occurrence (p = 0.04) and severity (p = 0.001) of acute nausea. No significant differences in anticipatory CINV and QoL were found among the groups.ConclusionThe use of AA plus standard antiemetic treatment and care was superior to the use of standard antiemetic treatment and care alone in managing CINV among BC patients receiving chemotherapy. The antiemetic effects of AA were identified to be more profound in improving acute CINV, particularly acute nausea. The antiemetic effects of AA were deemed to be a mixture of specific treatment effects and placebo effects, and the placebo effects were very large and even reached clinical significance.Trial registrationClinicalTrials.gov; NCT02403037; Registered March 31, 2015.

Addition of metoclopramide to triple antiemetic therapy towards prevention of anthracycline-based chemotherapy-induced nausea and vomiting in breast cancer patients

Objective: The aim of this study was to evaluate if addition of metoclopramide to the triplet antiemetic therapy is superior to the triplet antiemetic therapy for prevention of delayed chemotherapy-induced nausea and vomiting. Materials and Methods: A randomized single-blind trial was performed on 200 chemotherapy-naïve breast cancer patients who have to receive anthracycline-based highly emetogenic chemotherapy (HEC). The patients were randomized to study arm (n = 100) and control arm (n = 100). Triplet antiemetic therapy (fosaprepitant on day 1, 5-HT3 antagonist on day 1, and dexamethasone for days 1–4) was used in both the arms and metoclopramide (day 1–5) was added to the study arm. Response to antiemetic prophylaxis was assessed in terms of “complete response (CR),” “only nausea,” and “both nausea and vomiting.” CR is defined as no nausea, no vomiting, and no rescue medication during the overall phase (days 1–5). Nausea/vomiting was detected by using the Visual Analog Scale and its impact on quality of life was determined by using the Functional Living Index Emesis (FLIE) score. Results: The demographical and clinical features were similar in both the groups. Majority of patients in both the arms presented with Eastern Cooperative Oncology Group PS 0, Stage III, and positive hormone receptor status. CR was observed more in the study arm than that of the control arm (51% vs. 37%; P = 0.046). The mean total FLIE score was 29.23 in the study arm and 31.16 in the control arm (P = 0.036). Conclusion: This study resulted in a significant CR and clinically relevant improvement in FLIE score for addition of metoclopramide to triple antiemetic prophylaxis. Therefore, a quadruple antiemetic combination including metoclopramide might be an antiemetic prophylaxis option for breast cancer patients receiving anthracycline-based HEC for better compliance to treatment.

Bebas Mual Muntah Akibat Kemoterapi dengan Terapi Komplementer pada Pasien Kanker Payudara

This study aims to identify various complementary therapies that can overcome nausea and vomiting in breast cancer patients receiving chemotherapy. The method used is a literature search from different online databases. The results showed several complementary therapies to treat nausea and vomiting in breast cancer patients receiving chemotherapy, such as acupressure, yoga, acupuncture, foot massage therapy, breathing exercises and guided imagery combined with progressive muscle relaxation. In conclusion, several complementary therapies are significantly effective in overcoming nausea and vomiting in breast cancer patients receiving chemotherapy.
 Keywords: Breast Cancer, Nausea Vomiting, Complementary Therapy

Chemotherapy-Induced Nausea and Vomiting in Breast Cancer Patients: A Multicenter Prospective Observational Study

Objective:This study aimed to assess the occurrence of chemotherapy-induced nausea and vomiting (CINV) in acute phase (24 h after chemotherapy) and delayed phase (2–5 days after chemotherapy) after standard antiemetic therapy and to explore the risk factors of CINV in the acute and delayed phases.Methods:This prospective and observational study analyzed the data of 400 breast cancer patients scheduled for chemotherapy in two hospitals. The self-report survey was developed to assess the occurrence of CINV and their associated factors. On day 2 and day 6 of chemotherapy, CINV was evaluated by the Multinational Association of Supportive Care in Cancer Antiemetic Tool (MAT). The incidence of acute and delayed CINV was expressed as frequency and percentage.Results:Among 400 patients, 29.8% and 23.5% experienced acute and delayed CINV, respectively. Logistic regression analysis showed that the risk factors associated with acute CINV included pain/insomnia, history of CINV, and highly emetogenic chemotherapy. The history of motion sickness (MS), history of CINV, number of chemotherapy cycles completed, and the incidence of acute CINV were significant risk factors for delayed CINV (all P < 0.05).Conclusions:The results of this study are helpful for nurses to identify high-risk patients with CINV, formulate effective treatment plans, and reduce the incidence of CINV.

Development and validation of an evidence-based auricular acupressure intervention for managing chemotherapy-induced nausea and vomiting in breast cancer patients

BackgroundAuricular therapy (AT) has been utilized as a promising complementary health approach to alleviating chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients. However, current evidence on AT for CINV management has been inconclusive, and relevant AT treatment protocols have varied considerably in the intervention dosage and acupoint formula without an evidence-informed intervention protocol tailored to CINV symptoms. This study aimed to develop an evidence-based AT intervention protocol for CINV management in breast cancer patients receiving chemotherapy. MethodsThis study adopted the Medical Research Council Framework for Developing and Evaluating Complex Interventions (the MRC framework) to guide the AT intervention development process. The process consists of four steps: identification of the evidence base, identification of theories and practice standards, identification of cancer symptom characteristics, and modelling and validation. The preliminary AT intervention was then evaluated through a content validity study to identify its theoretical and practical appropriateness. The content validity index (CVI) was used to determine the consensus level of the panel. ResultsA preliminary AT intervention protocol, including a true AT intervention and a sham AT intervention, was developed based on research evidence identified from five systematic reviews, the homuncular reflex theory, the zang-fu organs and meridian theory, relevant AT practice standards, and the natural symptom progress of CINV. The true AT was designed as a daily manual acupressure for five consecutive days. While the sham AT was designed with the same intervention duration and acupoint formula as the true AT without manual acupressure. The content validity study demonstrated excellent consensus among the expert panel to support the AT intervention as a theoretically and practically feasible program with the item-level CVI ranging from 0.83 to 1.0 and the scale-level CVI reaching 1.0. ConclusionThis study followed the MRC framework to develop an evidence-based AT intervention for CINV management which is well supported by systematic review research evidence, AT theories and practice standards, CINV symptom characteristics, and expert panel consensus. The AT intervention would be further evaluated in a pilot randomised controlled trial to confirm its utility, feasibility and acceptability in clinical settings.

Qualitative study of breast surgery nurses on the cognitive and management of expected nausea and vomiting in patients with breast cancer

Objective To understand the cognitive and management status of breast cancer patients with expectant nausea and vomiting in breast cancer patients, and to provide reference for taking targeted measures to improve the symptoms of nausea and vomiting. Methods From March to May 2018, 10 breast surgical nurses were selected by the purpose sampling method. The phenomenological research methods in qualitative research were used to interview them. The Colaizzi data analysis principle was used to analyze the data and refine the theme. Results A total of five themes were extracted: nurses generally knew the impact of nausea and vomiting on patients; lack of knowledge about the expected nausea and vomiting of chemotherapy; nausea and vomiting has not been evaluated as an independent symptom; there is still no targeted, systematic management Measures; lack of attention is a major obstacle to the management of nausea and vomiting in patients. Conclusion Nurses should strengthen the knowledge of chemotherapy-predicted nausea and vomiting in breast cancer patients, and effectively evaluate patients with nausea and vomiting. Nursing managers should formulate corresponding standardized interventions to improve patients' nausea and vomiting according to the existing problems. Improve the quality of life of patients. Key words: Nurses; Breast neoplasms; Chemotherapy; Expectative nausea and vomiting; Cognition; Qualitative research

Effectiveness of acupressure Technique on Chemotherapy Induced Nausea and Vomiting among Breast Cancer Women: An Intervention Study

Background: Nausea and vomiting are the most common side effects associated with the usage of chemotherapy among breast cancer women. Aim of this study was to investigate the effectiveness of acupressure on chemotherapy-induced nausea and vomiting among breast cancer women. Research design: Quasi-experimental design was used to achieve the aim of the current study. Setting : The current study was conducted in outpatient oncology clinics at Zagazig University Hospitals. Subjects: Breast cancer women were divided into two groups (acupressure and control). They are on routine care and regular treatment. Tools: Interview questionnaire consists of four parts were used for data collection: Demographic characteristics and medical history, risk factors for nausea and vomiting, awareness regarding complementary therapy and the Index of Nausea, Vomiting and Retching (INVR). Results: The results showed that the mean scores of total occurrence, experience, distress for nausea ,vomiting ,retching in acupressure group were statistically significant decreased compared to control group throughout follow up days (p<0.05). Conclusion: Acupressure technique is positively affect nausea, vomiting and retching among breast cancer patients. Recommendation: Acupressure as technique should be carried out as supportive nursing intervention to relieve chemotherapy induced nausea and vomiting in breast cancer patients.

The effect of ginger (Zingiber officinale) on chemotherapy-induced nausea and vomiting in breast cancer patients: A systematic literature review of randomized controlled trials.

Breast cancer is the most commonly diagnosed cancer and is the leading cause of mortality due to all types of cancers among the female population worldwide. Results of clinical trials investigating the effect of ginger on chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients are inconsistent. This study was aimed at obtaining a comprehensive overview of the current evidence regarding the effectiveness of ginger as an antiemetic modality for controlling CINV in breast cancer patients. All published randomized controlled trials in English were systematically searched on Google Scholar, PubMed, Scopus, and Cochrane search databases up to June 2018. The outcome variable of interest was severity and the frequency of nausea and vomiting in patients. A total of 50 studies were found through search databases. After excluding duplicates, the 42 remaining studies were screened, and finally, nine trials were included, which were published between 2012 and 2017. Two studies have examined the effect of ginger on the frequency of nausea, five studies on the frequency of vomiting, seven studies on the severity of nausea, and three studies on severity of vomiting. A study evaluated the effectiveness of ginger in improving dietary intake in CINV. Our investigation suggests that ginger may reduce nausea in the acute phase of chemotherapy in patients with breast cancer. The effect of ginger on nausea and vomiting in other conditions requires more high-quality clinical trials.

THE EFFECT OF ACUPRESSURE WRISTBAND ON NAUSEA VOMITING IN BREAST CANCER PATIENTS WHO RECEIVED CHEMOTHERAPY

Chemotherapy is one of the therapies for cancer patients that cause some side effects, one of them is nausea and vomiting. Nausea and vomiting are still felt by patients even though they take antiemetics. Nausea dan vomiting can cause fluid and electrolyte imbalance. The aim of this study was to analysis the effect of combination acupressure wristband and antiemetic among chemotherapy induced nausea vomiting (CINV) on breast cancer patients. This research used quasi experimental research method, with a pre-post test with the control group. The sampling techniques was consecutive sampling with 25 respondents both in intervention group and control group. In the intervention group had received an acupressure wristband. CINV measured on the second day until fourth day after chemotherapy. Nausea and vomiting score were measured twice a day by a telemonitoring methode by Rhodes Index Nausea, Vomiting and Retching (INVR) questionaire. Data were analyzed by paired t-test, independent t-test, Wilcoxon test and Mann Whitney. The result of this study showed that acupressure wristband significantly reduce the chemotherapy induced nausea and vomit (p value = 0.000). The use of acupressure wristband combined with antiemetic therapy can significantly decrease chemotherapy induced nausea and vomiting in breast cancer patients. Acupressure wristband recommended for consideration nursing intervention in treating breast cancer patients who experience nausea and vomiting.

The Role of Hypnosis in Cancer Care.

This paper reviews the current evidence-base for the use of hypnosis as an adjunct treatment for common cancer-related symptoms and side effects, including those experienced during treatment, as well as long-term and late effects. First, a general description and history of medical hypnosis in cancer care is provided, followed by a review of the latest evidence across a range of common symptoms. The evidence suggests that hypnosis may help treat symptoms of nausea and vomiting in breast cancer patients, manage pain in a variety of contexts, and also reduce levels of anxiety and overall distress around surgical and medical procedures, both in children and adults. Emerging research shows promise for treating hot flashes in women with breast cancer. The research in this area would benefit from assessing populations beyond women with breast cancer, including late-stage disease, using more rigorous study designs, following published reporting guidelines and better describing and standardizing interventions.

Incidence of nausea and vomiting in breast cancer patients treated with anthracycline plus cyclophosphamide-based chemotherapy regimens in Italy: NAVY observational study.

Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event with cancer chemotherapy, despite the availability of effective antiemetic agents. This is a prospective observational study of Italian breast cancer patients treated with anthracycline plus cyclophosphamide (AC), assessed CINV incidence, adherence to national antiemetic guidelines (AIOM 2012), and the relationship with CINV outcomes. Patients with breast cancer scheduled to receive their first cycle of an AC-based regimen were enrolled at 12 Italian centers and their clinical data prospectively recorded. CINV incidence was assessed from patient diaries after the first chemotherapy cycle. The relationship between guideline adherence and CINV outcomes was examined using multiple logistic regression. The overall incidence rates of nausea and vomiting among 246 evaluable patients were 63.0 and 25.4%, respectively. Most patients received a 5-HT3-RA agent and dexamethasone for acute phase CINV prophylaxis, whereas a triple combination including aprepitant (NK1-RA), consistent with national guidelines, was used in only 45.5% of cases. In the delayed phase, the guideline adherence was 48.8%, while the overall adherence was 43.5%. After adjusting for confounding factors, adherence to antiemetic prophylaxis guidelines was associated with a significant reduction in the odds of three endpoints, namely any nausea, "significant nausea," and vomiting (OR = 0.49, OR = 0.54, and OR = 0.48, respectively), and a 90% increase in the odds of overall complete protection (OR = 1.90). CINV is still a critical issue in AC-treated patients, despite antiemetic treatment. Non-adherence to antiemetic guidelines may lead to poorer outcomes and indicates the need for strategies to enhance the use of guidelines in clinical practice.

Abstract P5-11-15: Rolapitant for the prevention of chemotherapy-induced nausea and vomiting in breast cancer patients receiving multiple cycles of emetogenic chemotherapy

Abstract Background: Patients (pts) with breast cancer often receive highly emetogenic chemotherapy, such as anthracycline plus cyclophosphamide (AC). Additionally, young age and female gender are risk factors for chemotherapy-induced nausea and vomiting (CINV) in response to emetogenic chemotherapy. We assessed the ability of the long-acting neurokinin-1 receptor antagonist (RA), rolapitant, in the prevention of CINV over multiple cycles in pts with breast cancer Methods: This is a post hoc analysis of the prevention of CINV in a subset of pts with breast cancer from 3 similarly-designed, randomized, placebo-controlled phase 3 trials in which pts received a single oral dose of 180 mg rolapitant or placebo before chemotherapy. All pts received an oral 5-HT3 RA + dexamethasone (active control). The regimens were cisplatin-based (n=36), AC-based (n=681) or other (n=166; carboplatin, cyclophosphamide, etc). Pts who completed cycle 1 could continue the same antiemetic treatment in multiple cycles. Endpoints for cycle 1 of chemotherapy included complete response (CR; no emesis and no use of rescue medication) and no emesis, and no nausea (maximum visual analogue scale [VAS] &amp;lt;5 mm), in the overall (0–120 h), acute (≤24 h), and delayed (&amp;gt;24–120 h) phases. On days 6-8 of each subsequent chemotherapy cycle, pts self-reported the incidence of emesis or nausea interfering with normal daily life. Results: In cycle 1, CR in both the overall (62.9% rolapitant, 55.1% control; p=0.018) and delayed (66.7% rolapitant, 59.7% control; p=0.032) phases were higher with rolapitant vs control . Rolapitant also improved no emesis rates in the overall (74.4% rolapitant, 62.6% control; p&amp;lt;0.001) and delayed (77.2% rolapitant, 68.5% control; p=0.004) phases. Although less pts were available for follow up over multiple cycles, a numerically greater proportion of rolapitant-treated pts than control pts reported no emesis (cycles 2-6) and no interfering nausea (cycles 2-5) (table). The incidence of treatment-emergent adverse events (TEAEs) was similar for rolapitant (85.2%) and control (83.2%) during cycles 1-6. The most common TEAEs occurred at comparable rates in the rolapitant and control arms: fatigue (28.5% and 29.4%, respectively), alopecia (28.5% and 31.2%, respectively), and constipation (20.0% and 20.9%, respectively). Conclusions: Rolapitant added to 5-HT3 RA and dexamethasone therapy improved CINV control and was safe and well-tolerated in pts with breast cancer receiving multiple cycles of emetogenic chemotherapy, mostly AC and carboplatin, historically a high-risk population for CINV. Pt-Reported Response in Multiple Cycles, % (n/N)* No Emesis No Interfering Nausea CycleRolapitant 180 mgActive Controlp-value *Rolapitant 180 mgActive Controlp-value *288.3 (323/366)80.0 (308/385)0.00271.6 (262/366)68.3 (263/385)0.329390.5 (297/328)80.5 (293/364)&amp;lt;0.00173.8 (242/328)65.9 (240/364)0.025487.5 (266/304)82.4 (277/336)0.07579.3 (241/304)72.0 (242/336)0.033594.9 (111/117)88.2 (127/144)0.05987.2 (102/117)80.6 (116/144)0.152695.3 (102/107)88.9 (120/135)0.07184.1 (90/107)83.0 (112/135)0.811* Unstratified Cochran-Mantel-Haenszel test for between rolapitant and control difference in response rate. Citation Format: Schwartzberg L, Navari R, Arora S, Powers D, Jordan K, Rapoport B. Rolapitant for the prevention of chemotherapy-induced nausea and vomiting in breast cancer patients receiving multiple cycles of emetogenic chemotherapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-11-15.

Efficacy of ginger for prophylaxis of chemotherapy-induced nausea and vomiting in breast cancer patients receiving adriamycin-cyclophosphamide regimen: a randomized, double-blind, placebo-controlled, crossover study.

The purpose of this study is to determine the efficacy of ginger for reducing chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients receiving adriamycin and cyclophosphamide (AC) regimens. We enrolled breast cancer patients receiving AC who experienced moderate to severe nausea or vomiting during the first chemotherapy cycle. Subjects were randomized to receive a 500-mg ginger capsule or placebo twice a day for 5days starting on the first day of the second AC cycle and were switched to the other treatment in the third cycle. All participants also received ondansetron and dexamethasone for CINV prophylaxis. Nausea severity was recorded once a day during the first 5days of each cycle. The primary outcome was reduction in nausea score. Thirty-four subjects (68cycles of AC) were enrolled. Mean (range) maximum nausea score in the first AC cycle was 58 (40-90). Thirty-three subjects (97%) received the same AC doses in the second as in the third cycle. Mean (±standard error) maximum nausea scores in patients receiving ginger and placebo were 35.36 (±4.43) and 32.17 (±3.71), respectively. The difference in mean maximum nausea scores was 3 (95% confidence interval, -3 to 9; P = 0.3). There were no significant differences between ginger and placebo in terms of vomiting incidence and severity, rescue medication use, chemotherapy compliance, and adverse events. Ginger (500mg) twice daily was safe, but conferred no additional benefit in terms of reducing nausea severity in breast cancer patients receiving AC and ondansetron and dexamethasone for CINV prophylaxis.

Guided imagery effects on chemotherapy induced nausea and vomiting in Iranian breast cancer patients

BackgroundThe objective of this study was to examine the effect of guided imagery on chemotherapy induced nausea and vomiting in breast cancer patients. DesignThis was a quasi-experimental study in which a group of sample was evaluated pre and post intervention. A convenience sample of 55 eligible breast cancer patients enrolled to participate in this study after giving informed consent. They completed the Morrow Assessment of Nausea and Vomiting, before and after the intervention. The intervention consisted of listening to the two guided imagery tracks. FindingsAfter the intervention, patients at the third session of chemotherapy had significantly lower mean scores in the frequency and severity of nausea and vomiting pre and post chemotherapy (p < 0.05). ConclusionsGuided imagery, as an inexpensive and noninvasive method, is particularly appealing option to alleviate chemotherapy induced nausea and vomiting. It can be used in addition to pharmacological strategies and can be implemented by patients independently with sufficient training. Therefore, this therapy will considerably improve severity and frequency of chemotherapy induced nausea and vomiting.

CP-135 Prevention and treatment of chemotherapy-induced nausea and vomiting in breast cancer patients

Background Pharmacists prescribe and monitor, in consensus with Oncology, individualised Post-Chemotherapy antiemetic regimes for all patients in our Hospital. Purpose To evaluate the quality and the acceptance of the antiemetic treatment prescribed to breast cancer (BC) patients in the last five years. Material and methods Retrospective observational study of BC patients treated with standard chemotherapy who received antiemetic treatment between 2008 and 2013. Depending on the emetogenic potential (EP) of the chemotherapy scheme, the pharmacist assigned and explained to the patient/family the most suitable antiemetic regime as: Low EP: metoclopramide 10–20 mg tds as needed (PRN). Moderate EP (Kit-1): dexamethasone 4 mg tds 2 days, then 4 mg bid 2 days, then 4 mg od 2 days, and metoclopramide 10–20 mg tds PRN. High EP (Kit-3): Kit-1 plus granisetron 1 mg in the evening following chemotherapy. If the patient had no emesis on the previous cycle, the regime was reduced, but if nausea/vomiting were felt, the regime was stepped up. Patient/family was always involved in treatment decisions. Patient data, prescriptions and monitoring were collected from the Oncofarm application and Pharmacy Database and analysed using SPSS. Results 93 BC patients (all female) received a total of 400 chemotherapy cycles. 357 antiemetic prescriptions were dispensed, so 89.25% of the time a patient received chemotherapy, came to pharmacy for antiemetic drugs. 87.3% of anti-emesis patients started with Kit-3, and 12.9% with kit-1. Antiemetics were reduced in 63.4% of patients, 15.1% continued with the same regime and 21.5% required reinforcement: taking metoclopramide around-the-clock (16.1%), stepping up from kit-1 to kit-3 (3.2%) or adding lorazepam due to anticipatory nausea/vomiting (2.2%). Conclusion The large number of antiemetic prescriptions states the good acceptance from patients of the healthcare provided by the pharmacy. Progressive reduction of antiemetics in more than 60% of patients shows the good control and monitoring of nausea/vomiting with the antiemetic treatment prescribed. References and/or Acknowledgements No conflict of interest.