Vomiting In Cancer Patients Research Articles

Comparison of Efficacy and Safety of Prophylactic Use of Metoclopramide and Haloperidol on Morphine-induced Nausea and Vomiting in Cancer Patients: A Comparative, Randomised, Prospective Study

Objectives: Morphine is the cornerstone of pain management in a palliative care setting. Nausea with or without vomiting usually occurs when patients are initiated on morphine for the 1st time or when the dose is substantially increased. Materials and Methods: A total of 90 patients fulfilling the inclusion criteria were randomly allocated into two groups of 45 each. Group M received a tablet of metoclopramide 10 mg orally 3 times a day; Group H received a tablet of haloperidol (2.5 mg) orally at night. All the patients were provided NCI CTCAE V4.3 NAUSEA AND VOMITING SCALE and asked to mark their response from day 1 to day 7. At the follow-up visit on the 7th day, the form was collected, and data were analysed. Results: In Group M and Group H, the mean nausea score was between 1 and 2 and the difference was statistically insignificant. In Group M, the maximum vomiting score was 1.28 on day 5, while in Group H, the maximum score was 2 on day 5. The difference between the two groups was statistically significant. Conclusion: Metoclopramide and haloperidol are equally efficacious in preventing nausea, but metoclopramide was found to be more effective with lesser side effects than haloperidol for morphine-induced vomiting in cancer patients when used prophylactically.

Serotonin Levels and Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Cross-Sectional Study.

Nausea and vomiting are distressing symptoms experienced by cancer patients undergoing treatment, impacting their physical well-being and quality of life. Serotonin, a neurotransmitter known for its role in regulating mood and gastrointestinal function, has been implicated in chemotherapy-induced nausea and vomiting (CINV). This study aimed to investigate serotonin level differences between CINV and non-CINV groups among cancer patients undergoing chemotherapy. An analytical observational investigation utilizing a cross-sectional design was conducted at Dr. Kariadi General Hospital from 2021-2022. Non-random consecutive sampling was employed to select participants meeting inclusion criteria, including age between 18 and 65 years, undergoing chemotherapy, non-smoking, and no recent antibiotic use. Platelet-poor plasma samples were analyzed for serotonin levels using a radioimmunoassay kit (Microplate reader ELx800). This study included 61 subjects compared serotonin levels in two groups to investigate their potential association with chemotherapy-induced nausea and vomiting (CINV). The non-CINV group (n=31) had a median serotonin level of 70 (IQR: 20) ng/mL, while the CINV group (n=30) had a significantly higher median of 170 ng/mL (IQR: 50) ng/mL. Age was associated with a 1.2 ng/mL increase in serotonin per year (95% CI: 0.5-1.9, p = 0.002), adjusted for sex. Being male correlated with a 40 ng/mL increase (95% CI: 10-70, p = 0.010), adjusted for age. This study underscores the importance of understanding serotonin's role in CINV and highlights the need for tailored treatment approaches based on chemotherapy emetogenicity.

ChlorTox scale assessment, greenness, and whiteness evaluation of selective spectrophotometric analysis of dimenhydrinate and cinnarizine

Nausea and vomiting are considered common series side effects induced by chemotherapy treatment in cancer patients. This annoying side effect can impair the patient’s compliance to cancer treatment and affect their quality of life. Dimenhydrinate and cinnarizine in combined pharmaceutical dosage form is used to control chemotherapy induced nausea and vomiting in cancer patients. For safety, selective spectrophotometric methods based on novel dual resolution strategies were introduced to estimate dimenhydrinate and cinnarizine in presence of their harmful impurities namely benzophenone and 1- (diphenylmethyl)piperazine, respectively. These methods namely, dual ratio difference (DRD), dual ratio extraction (DRE) and dual absorbance extraction coupled with dual ratio extraction (DAE-DRE) were successfully performed to simultaneously analyze the drug of interests dimenhydrinate and cinnarizine in their pure form, synthetic mixtures and in market dosage form. Linearity ranges were 6.0–60.0 μg/mL and 3.0–30.0 μg/mL for dimenhydrinate and cinnarizine, respectively with good recovery% of Mean ± SD for all the proposed methods 99.82 ± 0.48, 99.79 ± 0.40, 100.14 ± 0.82, 100.03 ± 0.69, respectively. ICH guidelines were adhered in accordance with confirming validation of the proposed methods where fulfilling results were accomplished. Various unified greenness and whiteness assessment tools, such as the chlorTox scale, greenness index via spider chart, AGREE (The Analytical Greenness Metric), green certificate, and the RGB12 algorithm were employed in this research to assess the greenness and sustainability of the introduced UV-spectrophotometric methods in comparison to the reported HPLC method. As a result, these methods hold significant potential for utilization in the quality control department of pharmaceutical companies, contributing to enhanced pharmaceutical product analysis and overall sustainability practices.

Combinination Essential Ginger Oil and Acupressure Relaxation Techniques to Nausea and Vomiting

Introduction: Nausea and vomiting are effects of chemotherapy that can decrease in the health condition of cancer patients. Objective: The aim of this study was to determine the effect of the combination of essential ginger oil therapy and acupuncture relaxation techniques on nausea and vomiting in cancer patients undergoing chemotherapy. Methods: This research used a quasi-experimental design. The population of this study was 124 adults undergoing chemotherapy. Sampling used purpose-based sampling with a sample size of 34 respondents (17 people in the treatment group and 17 people in the control group). Nausea and vomiting were measured using the Rhodes Index Nausea, Vomitting and Retching instrument. Results: The study results showed that before receiving the intervention, the intervention group's nausea and vomiting score averaged around a score of 6, in the control group the mean score was around 6. After the intervention, the nausea and vomiting score of the intervention group was 2, in the control group 10. The Wilcoxon test showed a significant value (p < 0.001). Conclusion: The combination of essential ginger oil and Acupressure relaxation techniques helped to reduce nausea and vomiting due to chemotherapy in cancer patients. This means that an intervention given regularly can educe nausea and vomiting. Oncology nurses could give recommendation to the hospital to provide this intervention to the chemotherapy patients.

Latihan Relaksasi Secara General terhadap Tingkat Mual dan Muntah pada Pasien Kanker dengan Induksi Kemoterapi

This study aims to determine the effectiveness of general relaxation exercises on the level of nausea and vomiting in cancer patients receiving chemotherapy induction. The method used in this research is a systematic review of several databases through searches of trusted journals, such as Scopus, EBSCOhost, Springer Link, Proquest and Science Direck, Google Schooler with article analysis using the PRISMA method. The results of the study showed that a total of 10 articles had been analyzed in which there were several relaxation exercise interventions that were given generally and successively proven to reduce the level of nausea and vomiting in cancer patients who received chemotherapy induction. Conclusion: Providing relaxation exercise interventions in general is flexible, simple, easy to learn, and helps reduce the level of nausea and vomiting in cancer patients receiving chemotherapy induction. Keywords: General relaxation exercises, Cancer, Nausea, Vomiting

2020 ASCO, 2023 NCCN, 2023 MASCC/ESMO, and 2019 CCO: a comparison of antiemetic guidelines for the treatment of chemotherapy-induced nausea and vomiting in cancer patients.

Chemotherapy-induced nausea and vomiting (CINV) is a common toxicity that may impair the quality of life of patients with various malignancies ranging from early to end stages. In light of frequent changes to the guidelines for optimal management of CINV, we undertook this narrative review to compare the most recent guidelines published by ASCO (2020), NCCN (2023), MASCC/ESMO (2023), and CCO (2019). The processes undertaken by each organization to evaluate existing literature were also described. Although ASCO, NCCN, MASCC/ESMO, and CCO guidelines for the treatment and prevention of CINV share many fundamental similarities, the literature surrounding low and minimal emetic risk regimens is lacking. Current data regarding adherence to these guidelines is poor and warrants further investigation to improve care.

Abstract 5995: How FDA-approved drug, Aprepitant, induces immunogenic death of cancer cells

Abstract Aprepitant is a long-standing FDA approved anti-nausea drug, recently re-purposed as an early-stage anticancer agent; how aprepitant kills cancer cells was not well studied. We find that aprepitant kills human and mouse cancer cells by hyperactivating the stress response pathway, the anticipatory unfolded protein response (a-UPR), thereby inducing immune cell activating necrotic cell death. Aprepitant is a small molecule neurokinin-1 receptor (NK-1R) antagonist widely used to prevent nausea and vomiting in cancer patients undergoing chemotherapy. Recently aprepitant has shown promise in mouse xenograft studies of colon, lung and pancreatic cancer and melanoma. Since aprepitant was thought to trigger release of calcium stored in the lumen of the endoplasmic reticulum, the step that we showed triggers hyperactivation of the a-UPR by ErSO family anticancer agents, we explored the role of the a-UPR in aprepitant action. Aprepitatnt robustly activates the PERK arm of the UPR increasing p-PERK and peIF2α, inhibiting protein synthesis. Notably, aprepitant treatment results in ATP depletion and activation of AMPK. Aprepitant induced rapid cell death was not blocked by apoptosis inhibitors or necroptosis inhibitors. In both standard 2-dimensional cell culture and 3-dimensional organoid culture aprepitant-treated breast cancer cells displayed typical features of necrotic cell death, including cell swelling, membrane rupture, and cytoplasmic vacuolization. Cell death by necrosis and membrane rupture leads to release of immune cell activating cell contents termed damage-associated molecular patterns (DAMPs). Aprepitant treatment induces release of the classic DAMPs, HMGB1 and ATP and medium from aprepitant-treated breast cancer cells enhances migration of differentiated human THP-1 macrophage. Thus aprepitant and other necrosis inducing therapies elicit immunogenic cell death (ICD) and may have the potential to enhance adjuvant immunotherapy. Genome-wide CRISPR screens with negative selection against aprepitant and other studies are being used to explore the pathways of aprepitant induced cell death and evaluate its therapeutic efficacy. Since FDA-approved aprepitant has been widely used for many years, identifying its pathway of action will both accelerate its clinical transition as an anticancer agent and help identify patients whose genetic profiles make them most likely to benefit from aprepitant therapy. Citation Format: Xinyi Dai, Junyao Zhu, Sofia Perry, Qianjin Jiang, David J. Shapiro. How FDA-approved drug, Aprepitant, induces immunogenic death of cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5995.

Development and Validation of an Auricular Acupuncture Protocol for the Management of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients.

Auricular acupuncture (AA) has been used to manage chemotherapy-induced nausea and vomiting (CINV). However, the application of the technique varies widely among the clinical trials that test its effectiveness. The aim of the present study was to develop and clinically validate an AA protocol for the management of CINV in cancer patients. This study was carried out in two stages: (1) development of the AA protocol for the management of CINV and (2) clinical validation of the protocol. The content validity of the protocol was determined by a panel of specialists, with an agreement rate ranging from 85.7% to 100%. In the clinical validation, when administered to cancer patients, the protocol developed has been shown to reduce the incidence, frequency, severity, and length of nausea and vomiting following chemotherapy, as well as the severity of nausea and anticipatory nausea following chemotherapy. This protocol needs to be tested in future studies, including a pilot study with a sham group and a randomized clinical trial, in order to further evaluate its feasibility, acceptability, safety, and clinical usefulness for the management of CINV.

Prevention and Care of Nausea and Vomiting in Cancer Patients After Chemotherapy

Prevention and Care of Nausea and Vomiting in Cancer Patients After Chemotherapy

Abstract B029: Genetic changes & polymorphisms of neurotransmitter receptors associated with chemotherapy-induced nausea and vomiting in cancer patients

Abstract Chemotherapy-induced nausea and vomiting (CINV) affect cancer patients’ survival and quality of life, despite antiemetic intervention. Polymorphisms in genes involved in nausea and vomiting pathways may influence the risk of CINV response in most cancer patients, who still present with acute and delayed CINV. Hence, this study aimed at profiling Single Nucleotide Polymorphisms (SNPs) of three clinically significant neurotransmitter-receptor encoding genes in cancer patients undergoing chemotherapy. This is a prospective cross-sectional study of 299 cancer patients undergoing chemotherapy, ages 18-75 years, who were selected across three tertiary healthcare institutions in South-west, Nigeria. Socio-demographic, clinical data and CINV occurrence responses were obtained using a self-designed questionnaire and patient interview post-chemotherapy. Target genes from genomic DNA extracted in collected blood samples were amplified by multiplex polymerase chain reaction. Nucleotide sequences were identified by Next Generation Sequencing and analyzed using bioinformatics software. P<0.05 was considered statistically significant for the association between identified SNPs and CINV. The majority of participants presented with advanced-stage cancer (stage 3) as compared to that early-stage 1. Cancer patients who experienced CINV were highly prevalent in breast cancer [84(62.9%); 41(30.60%)] and cervical cancer [33(50%); 33(45.46%)]. SNPs alongside their positions and frequencies were identified in the participants; HTR3A [(5’UTR; rs1062613(C>T), 9(45%)], DRD2 [Exon7; rs6277(G>A), 16(80%), intron 6; rs1076560 (C>A), 16(80%)], COMT [Exon 4; rs4680(G>A), 19(95%)] and TACR1 [Exon2; Y192H(T>C), 11(55%) and Exon 4; (rs17838409 (G>A)] respectively. None of the SNPs was significantly (P>0.05) associated with CINV occurrence. However, rs1062613, rs6277, and rs4680 were significantly (P<0.05) associated with vomiting grade, while rs4680 was found to be significantly associated with nausea severity. The identified neurotransmitter receptors SNPs exert influence on CINV response in cancer patients. Citation Format: John Abiodun Obadipe, Titilola Aderonke Samuel, Oluyemi Akinloye, Mutiu Alani Jimoh, Adewunmi Olabimpe Alabi, Babatunde M. Alabi, Oluwabanke Temitope Adewusi, Valerie Odero-marah. Genetic changes & polymorphisms of neurotransmitter receptors associated with chemotherapy-induced nausea and vomiting in cancer patients [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B029.

Nursing Support for Nausea and Vomiting in Patients With Cancer: A Scoping Review.

Nausea and vomiting are symptoms commonly experienced by patients with advanced cancer and have a wide range of causes, including pharmacological interventions. Additionally, multiple factors often simultaneously cause nausea and vomiting. These highly distressing symptoms may be directly or indirectly related to the disease and can significantly impact both the physical and psychological well-being of patients. This study aims to identify the nursing support provided to reduce nausea and vomiting experienced by patients with cancer. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist and Arksey and O'Malley's framework. We searched the PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Central Register of Controlled Trials in the Cochrane Library, and the Ichushi-Web of the Japan Medical Abstract Society databases for all content published from the inception of each database through July 31, 2023. A total of 4,625 scientific articles were identified after literature screening. In total, 58 articles were included for full-text review, and 10 articles were finally selected for review. The types of study designs comprised six randomized controlled trials, three prospective observational studies, and one before-after study with no controls. The types of cancers included in the articles were colorectal, breast, lung, pancreatic, gynecological, stomach, and sarcoma. The total sample size of the study population was 793 patients (range = 12-281) for intervention studies and 4,333 patients (range = 20-4,197) for observational studies. Nursing support, extracted from the 10 articles, was classified into the following six types: massage therapy, acupressure, early palliative care, psychosocial support, self-symptom monitoring, and coordinated care. The review yielded six classifications of nursing support for nausea and vomiting in cancer patients. Future research should examine the feasibility of providing nursing support for nausea and vomiting in cancer patients.

A Randomized Clinical Trial Investigating an Integrated Nursing Educational Program to Mitigate Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: The NIV-EC Trial

Background: In addition to pharmacological prevention, chemotherapy-induced nausea and vomiting (CINV) can be mitigated through patient education; written supporting materials can be beneficial. Methods: This is a randomized, controlled trial which randomly assigned patients undergoing first chemotherapy cycle to receive oral information regarding CINV prevention and management (control arm) or oral information plus an informative booklet (experimental arm). Overall, 384 cancer patients fulfilling the following inclusion criteria were enrolled: age ≥18 years; life expectancy ≥6 months; no cognitive impairment; written informed consent. After the first cycle, CINV occurrence and its impact on daily activities were assessed using the Functional Living Index Emesis (FLIE). Results: Severe nausea was self-reported by 3.0% and 10.8% of patients in the experimental and control group, respectively (difference: 7.8%; 95% confidence interval: 2.3% to 13.1%). Moderate/high impact of nausea on daily activities was lower in patients also receiving the booklet than in the control group (4.2% and 10.1%, respectively; difference: 5.9%; 95% confidence interval: 0.3% to 11.5%). Vomiting was not statistically different between study arms. Conclusions: This integrated nursing approach was effective in aiding cancer patients in CINV self-management. Although the beneficial effect was moderate, this intervention demands minimal resources in terms of costs and time.

A deep learning-based interpretable decision tool for predicting high risk of chemotherapy-induced nausea and vomiting in cancer patients prescribed highly emetogenic chemotherapy.

This study aims to develop a risk prediction model for chemotherapy-induced nausea and vomiting (CINV) in cancer patients receiving highly emetogenic chemotherapy (HEC) and identify the variables that have the most significant impact on prediction. Data from Tianjin Medical University General Hospital were collected and subjected to stepwise data preprocessing. Deep learning algorithms, including deep forest, and typical machine learning algorithms such as support vector machine (SVM), categorical boosting (CatBoost), random forest, decision tree, and neural network were used to develop the prediction model. After training the model and conducting hyperparameter optimization (HPO) through cross-validation in the training set, the performance was evaluated using the test set. Shapley additive explanations (SHAP), partial dependence plot (PDP), and Local Interpretable Model-Agnostic Explanations (LIME) techniques were employed to explain the optimal model. Model performance was assessed using AUC, F1 score, accuracy, specificity, sensitivity, and Brier score. The deep forest model exhibited good discrimination, outperforming typical machine learning models, with an AUC of 0.850 (95%CI, 0.780-0.919), an F1 score of 0.757, an accuracy of 0.852, a specificity of 0.863, a sensitivity of 0.784, and a Brier score of 0.082. The top five important features in the model were creatinine clearance (Ccr), age, gender, anticipatory nausea and vomiting, and antiemetic regimen. Among these, Ccr had the most significant predictive value. The risk of CINV decreased with increased Ccr and age, while it was higher in the presence of anticipatory nausea and vomiting, female gender, and non-standard antiemetic regimen. The deep forest model demonstrated good discrimination in predicting the risk of CINV in cancer patients prescribed HEC. Kidney function, as represented by Ccr, played a crucial role in the model's prediction. The clinical application of this predictive tool can help assess individual risks and improve patient care by proactively optimizing the use of antiemetics in cancer patients receiving HEC.

Cross-cultural adaptation of COSTaRS Practice Guidelines for the management of chemotherapy-associated nausea and vomiting in cancer patients

Cross-cultural adaptation of COSTaRS Practice Guidelines for the management of chemotherapy-associated nausea and vomiting in cancer patients

Acupuncture for the prevention of chemotherapy-induced nausea and vomiting in cancer patients: A systematic review and meta-analysis.

To assess the effectiveness and safety of acupuncture for the prevention of chemotherapy-induced nausea and vomiting (CINV), with a specific intention on exploring sources of between-study variation in treatment effects. MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodicals Database, China National Knowledge Infrastructure, and Wanfang were searched to identify randomized controlled trials (RCTs) that compared acupuncture to sham acupuncture or usual care (UC). The main outcome is complete control (no vomiting episodes and/or no more than mild nausea) of CINV. GRADE approach was used to rate the certainty of evidence. Thirty-eight RCTs with a total of 2503 patients were evaluated. Acupuncture in addition to UC may increase the complete control of acute vomiting (RR, 1.13; 95% CI, 1.02 to 1.25; 10 studies) and delayed vomiting (RR, 1.47; 95% CI, 1.07 to 2.00; 10 studies) when compared with UC only. No effects were found for all other review outcomes. The certainty of evidence was generally low or very low. None of the predefined moderators changed the overall findings, but in an exploratory moderator analysis we found that an adequate reporting of planned rescue antiemetics might decrease the effect size of complete control of acute vomiting (p = 0.035). Acupuncture in addition to usual care may increase the complete control of chemotherapy-induced acute vomiting and delayed vomiting but the certainty of evidence was very low. Well-designed RCTs with larger sample sizes, standardized treatment regimens, and core outcome measures are needed.

Can olanzapine preserve life quality in cancer patients undergoing abdominal radiation therapy?

Nausea and vomiting, are the distressing symptoms of radiation therapy in cancer patients. About 40–80% of cancer patients may experience nausea and vomiting during abdominal radiotherapy. Studies revealed that majority of patients do not achieve complete control of nausea and vomiting while using standard anti-emetic regimens. American Society of Clinical Oncology highlights radiotherapy induced nausea and vomiting (RINV) as an understudied area. Nausea and vomiting induced by radiation therapy is underestimated and under-treated by physicians. This affects quality of life and also delay in completion of the subsequent radiation schedules in some patients. Olanzapine, an atypical anti-psychotic agent approved by FDA in 1996, has shown promising results in both prevention and rescue of chemotherapy induced nausea and vomiting (CINV). But its role in RINV has not yet been studied. Olanzapine, because of its action on multiple receptors, especially, those mediating nausea and vomiting (D2, 5-HT2C, and 5-HT3 receptors) is expected to exert an anti-emetic action. Olanzapine also increases appetite, acting via the H1, 5-HT2B, and 5-HT2C receptors. Therefore we hypothesis that olanzapine can accomplish better control of nausea and vomiting in cancer patients undergoing radiation therapy since it has inhibitory activity on neurotransmitters at multiple receptors involved in nausea and vomiting. In addition, it will also improve their quality of life in cancer patients.

Acupuncture for cancer patients with nausea and vomiting: A protocol for systematic review and meta-analysis.

Nausea and vomiting are among the most common adverse effects experienced by cancer patients undergoing treatment worldwide. Their treatment with pharmacologic therapy can often be complicated by medication interactions and other unwanted side effects. The aim of this systematic review and meta-analysis protocol is to assess the effectiveness and safety of acupuncture therapy for treating nausea and vomiting in patients with cancer. Three electronic databases and 2 clinical registry platforms will be searched from inception to May 2022: the MEDLINE via PubMed, Embase via Ovid, the Cochrane Central Register of Controlled Trials via the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, and National Institutes of Health Clinical trials.gov. Search terms will include nausea, vomiting, cancer, and acupuncture. Two researchers will independently select studies, extract data and assess the risk of bias. The primary outcome will be the incidence of nausea and/or vomiting or other validated outcome measures. Meta-analysis will be carried out using RevMan V.5.4. The quality of evidence from randomized clinical trials will be evaluated with the Grading of Recommendations Assessment, Development and Evaluation System tool. The results will provide a high-quality synthesis of evidence for clinicians in the field of oncology. The conclusion is expected to provide evidence to determine whether acupuncture is an effective and safe treatment for cancer patients with nausea and vomiting.

Summary of the Best Evidence for the Evaluation and Management of Chemotherapy-Related Nausea and Vomiting in Cancer Patients

Objective: To summarize the best evidence for the evaluation and management of chemotherapy-related nausea and vomiting in cancer patients, so as to promote the standardized management of chemotherapy-related nausea and vomiting in cancer patients. Methods: A computer search was conducted for all evidence on chemotherapy-associated nausea and vomiting interventions, including guidelines, expert consensus, best clinical practice information booklet, recommended practice, evidence summary, and systematic review. The search period is from April 30, 2022. After the literature quality evaluation, the evidence extraction and summary of the literature meeting the quality standards. Results: A total of 16 literatures were included, including 9 guidelines, 5 systematic reviews and 2 expert consensus papers. 46 pieces of best evidence on the assessment and management of chemotherapy related nausea and vomiting in cancer patients were summarized, including 6 aspects including risk assessment and management, non-drug management, drug management, multidisciplinary cooperation, education and training, and health education. Conclusion: This study summarized the current best evidence on the assessment and management of chemotherapy-related nausea and vomiting in cancer patients. Clinical staff should apply evidence according to specific clinical scenarios, professional skills and patients’ wishes in order to reduce the degree and incidence of chemotherapy-related nausea and vomiting in cancer patients and improve the quality of care.

Evaluation of acupuncture and auriculotherapy in the control of chemotherapy-induced nausea and vomiting: a Pilot Study.

To evaluate the effectiveness of acupuncture and auriculotherapy protocol in relieving chemotherapy-induced nausea and vomiting in cancer patients compared to the antiemetic protocol. Pilot study of a pragmatic two-arm clinical trial: an acupuncture group received systemic acupuncture, auriculotherapy, and antiemetic protocol; a control group used antiemetic protocol. The sample consisted of 42 patients with cancer of the gastrointestinal system or multiple myeloma. The outcome was assessed using the Chemotherapy-Induced Nausea and Vomiting Assessment Tool and the patient's diary. There was no statistically significant difference between groups according to the assessment of the patient's diary and the Assessment Tool of chemotherapy-induced nausea and vomiting. The patients were 60 years old on average and the groups were homogeneous, except for marital status. In the diary, there was no statistical difference between groups and sessions for days of nausea (p = 0.873) and vomiting episodes (p = 0.993). The protocol of acupuncture and auriculotherapy as a complementary treatment of chemotherapy-induced nausea and vomiting was ineffective, considering the limitations of the study.

Efficacy of Olanzapine for Symptom Relief in Cancer Patients

Olanzapine is an atypical antipsychotic and is widely used for prophylaxis of chemotherapy-induced nausea and vomiting in cancer patients. Previous studies have suggested its potential efficacy for the relief of various symptoms in cancer patients, especially gastrointestinal and psychiatric symptoms. We retrospectively reviewed the prescription of olanzapine to cancer patients at our hospital. Between 2008 and 2020, olanzapine was prescribed to 41 patients for relief of symptoms associated with cancer other than prophylaxis of chemotherapy-induced nausea and vomiting. Of those patients, symptom relief was seen in 53.7%. Notably, olanzapine was effective in 13 of 14 patients with chemotherapy-induced nausea and vomiting refractory to guideline-recommended prophylaxis. Of 16 patients in whom this symptom was not relieved by olanzapine, 13 (81.3%) continued taking olanzapine even after it was judged ineffective. No treatment-related adverse events were seen in this study. Our observation implies good efficacy of olanzapine for refractory chemotherapy-induced nausea and vomiting and a tendency to continue olanzapine even in those for whom it was ineffective.