Vomiting In Cancer Patients Research Articles

1290P The effect of electric massage chair on chemotherapy-induced nausea and vomiting in cancer patients

Chemotherapy-induced nausea and vomiting (CINV) are the most common and serious side effects of chemotherapy. Multiple antiemetic agents are widely used to reduce CINV, but they are not completely control the symptom and often cause undesirable side effects. There has been evidence that massage therapy helps cancer patients physically and emotionally, improving quality-of-life (QoL). This study was conducted to evaluate clinical role of electric massage chair to relieve CINV as an alternative therapy.

Cisplatin-Induced Anorexia and Pica Behavior in Rats Enhanced by Chronic Stress Pretreatment.

Background: Chemotherapy-induced nausea and vomiting severely impairs the treatment and prognosis of cancer patients. Depressive mood disorder might aggravate nausea and vomiting in cancer patients; however, the role of neurotransmitters and receptors involved in the mediation of emesis and nausea is still not well elaborated. Methods: The study was carried out based on the chronic unpredictable mild stress–induced depression-like phenotype rat model and cisplatin-induced pica rat model establishment. Forty male Sprague–Dawley rats were randomized into the non-treated control group and the chronic stress group, which were exposed to 8 weeks of stress. Each group was then sub-divided into vehicle subgroups (n = 10) and cisplatin subgroups (n = 10) which were given cisplatin to induce pica behavior. Kaolin and food intake were recorded after administration. The medulla oblongata and ileum tissues were obtained. Neurotransmitters involved in the mediation of emesis and nausea (5-HT, DA, SP, and AEA) were detected using an ELISA kit. Vomit-related receptors (5-HT3R, DA2R, NK1R, and CB1R) in tissues were assayed for mRNA and protein expression by RT-qPCR and Western blotting. Results: Behavioral test and sucrose preference validated that depression-like phenotype rat models were established successfully. The kaolin consumption test confirmed that chronic stress pretreatment aggravated anorexia and pica behavior. Vomiting-related molecules’ data showed that chronic stress exposure increased 5-HT and SP levels in the medulla oblongata. Vomiting-related receptor expression data showed that chronic stress pretreatment upregulated 5-HT3R, DA2R, and NK1R expressions and downregulated the CB1R expression in the medulla oblongata. However, chronic stress pretreatment downregulated 5-HT3R, DA2R, and NK1R expressions and upregulated the CB1R expression in the ileum. Conclusion: Chronic stress pretreatment aggravates anorexia and vomiting progress, which might be via altering neurotransmitters and receptors involved in the mediation of emesis and the nausea level and expression in the central nervous system.

Use of acupressure to reduce nausea and vomiting in cancer patients receiving chemotherapy (literature study)

Use of acupressure to reduce nausea and vomiting in cancer patients receiving chemotherapy (literature study)

Prevalence of antecipatory nausea and vomiting in cancer patients exposed to highly emetogenic chemotherapy.

e24112 Background: Anticipatory nausea (AN) and vomiting are unpleasant symptoms observed in anticipation of chemotherapy regimens. It is best described as a learned response through classical conditioning when one or more distinctive features of the chemotherapy clinic (conditioned stimuli) associated with the administration of emetogenic chemotherapy (unconditioned stimuli) trigger the emetogenic reflex. Little is known about AN's occurrence after the advent of the new neurokinin-1 antagonist. This prospective study evaluated AN's prevalence in ambulatory breast cancer patients receiving high effective antiemetic prophylaxis and evaluated potential predictors of AN. Methods: This prospective observational study was performed at a single Brazilian Institution. Key inclusion criteria were patients aged 18 years or older with breast cancer scheduled to receive anthracycline chemotherapy with an appropriate antiemetic regimen, including a neurokinin-1 receptor antagonist, a serotonin-3 receptor antagonist, and a corticosteroid. Eligible patients used a diary to record nausea, vomiting, and use of rescue medication in the first 2-cycle of treatment through 120 after infusion. AN was assessed before chemotherapy on day 1 of cycle two. We excluded patients with nausea and vomiting presented 24h before cycle one and patients who did not receive standard antiemetic prophylaxis. Results: Between August 04, 2020, and August 12, 2021, 60 patients were screened, and 52 patients were enrolled. The mean age was 50,8 (28 – 69), the majority had stage III (53,8%) and received chemotherapy with curative intent (94%). During cycle 1, the frequency of overall nausea and vomiting was 67.31%, and severe nausea and vomiting (defined as grade > 4 at a 10-point visual scale or use of rescue medication) was 55.77%. Ten patients had AN (19.23%). The occurrence of nausea and vomiting during cycle one was the only statistically significant predictor of AN (OR = 16, 95% CI 2.4, 670.9, p-value = 0.0003). Conclusions: The prevalence of AN is still high in the era of neurokinin-1 antagonists, and failure of antiemetic control on cycle one remains the main risk factor. All efforts should be made to control chemotherapy-induced nausea or nausea and vomiting on cycle one to avoid AN. Clinical trial information: NCT04785495.

A real-world study to evaluate the safety and efficacy of three injectable neurokinin-1 receptor antagonist formulations for the prevention of chemotherapy-induced nausea and vomiting in cancer patients

BackgroundThree different injectable neurokinin-1 (NK-1) receptor antagonist formulations (CINVANTI® [C] vs. intravenous Emend® [E] vs. generic formulations of fosaprepitant [GFF]) were compared with respect to nausea and vomiting control, use of rescue therapy, and the development of infusion reactions over multiple cycles of chemotherapy.MethodsA retrospective analysis from 17 community oncology practices across the USA was conducted on patients who received moderately or highly emetogenic chemotherapy. The co-primary endpoints were the control of chemotherapy-induced nausea and vomiting (CINV) from days 1 to 5 over all cycles and the frequency of infusion-related reactions. Propensity score weighted multivariable logistic regression analysis was used to compare complete CINV control, the use of rescue therapy, and the risk of infusion reactions between groups.ResultsThe study enrolled 294 patients (C = 101, E = 101, GFF = 92) who received 1432 cycles of chemotherapy. Using CINVANTI® as the reference group, comparative effectiveness was suggested in CINV control over all chemotherapy cycles (odds ratio (OR): E vs. C = 1.00 [0.54 to 1.86] and GFF vs. C = 1.12 [0.54 to 2.32]). However, use of rescue therapy was significantly higher in the EMEND® group relative to CINVANTI® (OR = 2.69; 95%CI: 1.06 to 6.84). Infusion reactions were also numerically higher in the EMEND® group, but the difference did not reach statistical significance (OR = 4.35; 95%CI: 0.83 to 22.8).ConclusionsIn this real-world analysis, patients receiving CINVANTI® had a reduced need for CINV rescue therapy and a numerically lower incidence of infusion reactions.

Terapi Akupresur Laser untuk Mengatasi Mual Muntah Akibat Kemoterapi pada Pasien Kanker di Ruang Kemoterapi

This study aims to determine the effect of laser acupuncture in overcoming nausea and vomiting due to chemotherapy in cancer patients. This research method is a literature review through the database Science Direct and Proquest, in the last five years, from 2015 to 2020. The results obtained in each article focus on oncology nurses' roles. In this context, oncology nurses have an essential role in relieving some of the symptoms of cancer, such as using different techniques to improve patients' quality of life and improve various treatment options to support recovery and health care for patients regarding treatment and rehabilitation. In conclusion, laser acupuncture is very safe and effective in reducing nausea and vomiting in cancer patients receiving chemotherapy treatment.
 
 Keywords: Chemotherapy, Laser Acupuncture, Nausea, Vomiting

Cannabinoids: Therapeutic Use in Clinical Practice

Medical case reports suggest that cannabinoids extracted from Cannabis sativa have therapeutic effects; however, the therapeutic employment is limited due to the psychotropic effect of its major component, Δ9-tetrahydrocannabinol (THC). The new scientific discoveries related to the endocannabinoid system, including new receptors, ligands, and mediators, allowed the development of new therapeutic targets for the treatment of several pathological disorders minimizing the undesirable psychotropic effects of some constituents of this plant. Today, FDA-approved drugs, such as nabiximols (a mixture of THC and non-psychoactive cannabidiol (CBD)), are employed in alleviating pain and spasticity in multiple sclerosis. Dronabinol and nabilone are used for the treatment of chemotherapy-induced nausea and vomiting in cancer patients. Dronabinol was approved for the treatment of anorexia in patients with AIDS (acquired immune deficiency syndrome). In this review, we highlighted the potential therapeutic efficacy of natural and synthetic cannabinoids and their clinical relevance in cancer, neurodegenerative and dermatological diseases, and viral infections.

A Novel Mechanism of Endoplasmic Reticulum Stress- and c-Myc-Degradation-Mediated Therapeutic Benefits of Antineurokinin-1 Receptor Drugs in Colorectal Cancer.

The neurokinin‐1 receptor (NK‐1R) antagonists are approved as treatment for chemotherapy‐associated nausea and vomiting in cancer patients. The emerging role of the substance P‐NK‐1R system in oncogenesis raises the possibility of repurposing well‐tolerated NK‐1R antagonists for cancer treatment. This study reports that human colorectal cancer (CRC) patients with high NK‐1R expression have poor survival, and NK‐1R antagonists SR140333 and aprepitant induce apoptotic cell death in CRC cells and inhibit CRC xenograft growth. This cytotoxicity induced by treatment with NK‐1R antagonists is mediated by induction of endoplasmic reticulum (ER) stress. ER stress triggers calcium release, resulting in the suppression of prosurvival extracellular signal‐regulated kinase (ERK)‐c‐Myc signaling. Along with ER calcium release, one ER stress pathway mediated by protein kinase RNA‐like ER kinase (PERK) is specifically activated, leading to increased expression of proapoptotic C/EBP‐homologous protein (CHOP). Moreover, NK‐1R antagonists enhance the efficacy of chemotherapy by increasing the sensitivity and overcoming resistance to 5‐fluorouracil in CRC cells through the induction of sustained ER stress and the consequent suppression of ERK‐c‐Myc signaling both in vitro and in vivo. Collectively, the findings provide novel mechanistic insights into the efficacy of NK‐1R antagonists either as a single agent or in combination with chemotherapy for cancer treatment.

Efficacy and safety of 5\u2009mg olanzapine for nausea and vomiting management in cancer patients receiving carboplatin: integrated study of three prospective multicenter phase II trials

BackgroundThe efficacy of olanzapine as an antiemetic agent in cancer chemotherapy has been demonstrated. However, few high-quality reports are available on the evaluation of olanzapine’s efficacy and safety at a low dose of 5 mg among patients treated with carboplatin regimens. Therefore, in this study, we investigated the efficacy and safety of 5 mg olanzapine for managing nausea and vomiting in cancer patients receiving carboplatin regimens and identified patient-related risk factors for carboplatin regimen-induced nausea and vomiting treated with 5 mg olanzapine.MethodsData were pooled for 140 patients from three multicenter, prospective, single-arm, open-label phase II studies evaluating the efficacy and safety of olanzapine for managing nausea and vomiting induced by carboplatin-based chemotherapy. Multivariable logistic regression analyses were performed to determine the patient-related risk factors.ResultsRegarding the endpoints of carboplatin regimen-induced nausea and vomiting control, the complete response, complete control, and total control rates during the overall study period were 87.9, 86.4, and 72.9%, respectively. No treatment-related adverse events of grade 3 or higher were observed. The multivariable logistic regression models revealed that only younger age was significantly associated with an increased risk of non-total control. Surprisingly, there was no significant difference in CINV control between the patients treated with or without neurokinin-1 receptor antagonist.ConclusionsThe findings suggest that antiemetic regimens containing low-dose (5 mg) olanzapine could be effective and safe for patients receiving carboplatin-based chemotherapy.

A Quasi-Experimental Study of the Effect of Ginger Tea on Preventing Nausea and Vomiting in Patients With Gynecological Cancers Receiving Cisplatin-Based Regimens.

Cancer patients receiving chemotherapy experience acute and delayed nausea and vomiting. These side effects obligate the patients to use pharmacological and nonpharmacological methods. The effect of ginger tea as an antiemetic modality on preventing chemotherapy-related nausea and vomiting has not been confirmed in previous studies. The aim of this study was to assess the effect of ginger tea, when given together with the standard antiemetic regimen, on preventing nausea and vomiting in patients with gynecological cancers receiving cisplatin-based regimens. This study used a quasi-experimental research design with 2 groups (control and intervention groups, 50 participants each). A sociodemographic and medical survey and the Modified Rhodes Index of Nausea, Vomiting, and Retching were used to collect the data. Descriptive analyses, t test, and χ2 test were used to analyze the data. The total mean Modified Rhodes Index of Nausea, Vomiting, and Retching scores were lower in the intervention group in all measurements compared with the control group, and the differences between the total mean scores for symptom experience, development, and distress between the groups were statistically significant in the third (P < .05), fourth (P < .01), and fifth (P < .05) measurements. No ginger-related side effects were noted in this study. Ginger tea reduced the experience, development, and distress of nausea, vomiting, and retching in the intervention group. The use of ginger tea may be recommended for chemotherapy-associated nausea and vomiting in cancer patients receiving cisplatin-based regimens. Oncology nurses can lead the implementation of ginger tea intervention to prevent chemotherapy-related nausea and vomiting.

Efficacy and Safety of 5-Hydroxytryptamine-3 Receptor Antagonists (5-HT3 RAs) for The Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Review

Objective: This review provides an update review of the efficacy and safety of 5-hydroxytryptamine-3 receptor antagonists in the prevention of chemotherapy-induced nausea and vomiting (CINV) in cancer patients.&#x0D; Methods: The information was collected from electronic scientific search engines from PubMed, Science Direct, Scopus, and Google Scholar. The publication dates covered were from 2010 to 2020. The primary endpoint was the percentage of patients who achieved a complete response (CR), complete control (CC), no nausea, no emesis, or no rescue medication.The secondary endpoint was the percentage of patients who experience constipation related to 5-HT RA constipation, headache, diarrhea, or dizziness, as well as changes in heart rhythm.&#x0D; Results: Fourteen articles were identified. Palonosetron has the same effectiveness as granisetron as but more effective than ondansetron in the delayed phase and overall. Adverse effects that often occur due to the use of palonosetron, granisetron, and ondansetron are constipation and headache. Some of the articles also mentioned that palonosetron does not cause changes in heart rhythm but granisetron and ondansetron do cause changes in the electrocardiogram (ECG) at certain doses.&#x0D; Conclusion: Palonosetron has the same effectiveness as granisetron, and more effective than ondansetron in delayed, and overall phases. The use of palonosetron, granisetron, and ondansetron cause constipation and headaches at all doses, palonosetron does not cause ECG abnormalities whereas granisetron and ondansetron cause ECG changes.&#x0D; Keywords: palonosetron, ondansetron, granisetron, 5-HT3 RAs, cancer, nausea, vomiting, CINV.

Aromaterapi Sebagai Terapi Komplementer untuk Mengatasi Nyeri, Depresi, Mual dan Muntah pada Pasien Kanker: A Literature Review

Introduction: Cancer is an abnormal cell growth that attacks the surrounding tissue which can cause death for the sufferer. Cancer is the second leading cause of death in the world by 13% after cardiovascular disease. Cancer can cause sufferers to experience a decrease in physical conditions such as pain and psychologically such as depression. One of the pharmacological therapies that can cure cancer is chemotherapy. Chemotherapy has side effects of myelosuppression, nausea and vomiting, causing discomfort for the sufferer. One of the complementary therapies that can reduce pain, depression and the effects of chemotherapy is aromatherapy. Methods: This study used 6 steps including, formulating research questions and objectives, searching for existing literature, screening according to inclusion, assessing article quality, extracting data, and analyzing data. Articles obtained from data based on Google Scholar. Using Indonesian keywords, namely: “Aromatherapy”, “Nausea”, “Vomiting”, “Cancer”, “Pain”, there were 5 articles that met the inclusion criteria and were included in the analysis. Results: Aromatherapy has been shown to be effective in reducing pain and depression in cancer patients as well as providing comfort to reduce nausea and vomiting due to the effects of chemotherapy administered by patients. Discussion: Complementary aromatherapy interventions have good benefits for cancer patients in reducing pain and depression and reducing nausea and vomiting. The provision of this therapy should be promoted more widely to patients and health professionals to support patient comfort. Conclusion: Aromatherapy can reduce pain and depression and reduce nausea and vomiting in cancer patients undergoing chemotherapy.&#x0D;

Efficacy of Ginger Use for Chemotherapy Induced Nausea and Vomiting in Cancer Patients: Scoping Review

Efficacy of Ginger Use for Chemotherapy Induced Nausea and Vomiting in Cancer Patients: Scoping Review

Analysis of Quality-of-Life (QoL) in Patients Receiving NEPA for Prevention of Chemotherapy-Induced Nausea (CINV) and Vomiting

Introduction: Chemotherapy-induced nausea and vomiting (CINV) is a common and distressing side effect that has a detrimental impact on QoL. For pts receiving highly emetogenic chemotherapy (HEC), which includes those on anthracycline-cyclophosphamide (AC)-based regimens, a triple combination of a neurokinin-1 receptor antagonist (NK1 RA), a 5-hydroxytryptamine-3 (5-HT3) RA and dexamethasone is recommended by the NCCN and MASCC/ESMO. The complexity of the NK1 RA-based schedules may be a reason for the low adherence to antiemetic guidelines and a not sufficient control of CINV in pts receiving HEC and MEC. NEPA is the only available fixed-combination antiemetic. It is composed of an NK1 RA, netupitant (300 mg) and a 5-HT3 RA, palonosetron (0.50 mg); thus, it acts by blocking two main emetic pathways in a single dose and eases compliance to guidelines. Methods: Prospective, non-interventional study at 162 sites in Germany from 09/2015 to 03/2018. The aim was to determine QoL of adult cancer pts receiving NEPA for the prevention of nausea and vomiting associated with 1 or 2 day HEC or MEC in daily clinical practice. The primary outcome was measured via the Functional Living Index-Emesis (FLIE) questionnaire. FLIE questionnaires were analyzed according to the FLIE scoring and administration manual v12; higher scores correlated to better performance on daily life activities due to the lower occurrence of nausea and vomiting. 'No impact on daily life (NIDL) activities' for individual nausea and vomiting domains was defined as a FLIE score higher than 53.8; NIDL for the combined domains of nausea and vomiting was defined as a FLIE score higher than 108. Secondary objectives included evaluating effectiveness, as determined by measuring the rate of complete response (CR) and rescue medication, as well as safety outcomes. Efficacy was documented by the treating physicians and via patient diaries for 3 Ctx cycles within 24 hrs and on 4 additional d after Ctx. Safety, additional medication and physicians' overall satisfaction was reported via eCRF. Results: A total of 2429 pts were enrolled, 2405 of whom were assessed for eligibility; of these, 2173 were included in the final analysis and constitute the full analysis set population (FAS). Evaluable FLIE questionnaires were collected from 1886 (88%) pts in cycle 1, 1795 (88%) pts in cycle 2 and 1698 (86%) pts in cycle 3. A total of 1389 pts received HEC and 764 MEC in cycle 1. The majority of pts (91%) were scheduled to receive 1-day ctx at study entry. More than half of the pts (1230, 56%) received anthracycline/cyclophosphamide-(AC), 19% carboplatin-, 8% cisplatin-, 7% oxaliplatin- and 9% other CTs. NIDL due to vomiting during cycle 1 was reported by 84% of pts in the HEC group and 82% in the MEC group. These frequencies were maintained in cycles 2 and 3. NIDL due to nausea increased from 54% in cycle 1 to 58% in cycle 3 for pts receiving HEC, and from 59% in cycle 1 to 66% in cycle 3 for pts in the MEC group. The rates for the combined domain of NIDL due to nausea and vomiting were consistent across cycle 1 (64%) and in cycles 2 and 3 (66% in each cycle) for pts in the HEC group, while the rates increased from 67% in cycle 1 to 73 and 74% in cycles 2 and 3, respectively, for pts receiving MEC. The CR rate (no emesis and no use of rescue medication) was 89% in the acute phase (0-24 h), 87% in the delayed phase (25-120 h) and 83% in the overall period (0-120 h) in cycle 1. The no significant nausea (NSN) rate was 79 % in the acute, 75 % in the delayed and 67 % in the overall phase in cycle. The majority of physicians (≥89%) and pts (≥86%) rated the effectiveness of NEPA prophylaxis as 'very good' or 'good' during all three ctx cycles. The most common NEPA-related AEs, which occurred in &amp;gt;1% of pts in the overall study period, were fatigue (3%), constipation (3%), nausea (2%) and insomnia (2%). There were no reports of NEPA-related deaths. Conclusions: Real-life data show that NEPA was effective in the prevention of chemotherapy-induced nausea and vomiting in cancer patients. NEPA had beneficial effects on the quality of life and was highly effective in the acute and delayed phase of HEC and MEC. NEPA antiemetic effectiveness was rated highly both by patients and physicians. Disclosures Karthaus: RIEMSER: Consultancy, Honoraria. Schilling:Riemser: Honoraria.

The incidence of nausea and vomiting in cancer patients in Greek clinical practice: A longitudinal study.

Aim of the studyTo assess nausea and vomiting in cancer patients during two cycles of chemotherapy, and the impact on their quality of life.Material and methodsA longitudinal study was conducted in an oncology department of a large general public hospital in Northern Greece. The sample consisted of 200 cancer patients. Data were collected with the MASCC-Antiemesis Tool and FACT-G questionnaire and specific demographic and clinical characteristics.ResultsIn cycle 2, acute vomiting was experienced by 16% of the patients and delayed vomiting by 14%; acute nausea was experienced by 27.5% and delayed nausea by 38%. In cycle 3, acute and delayed vomiting were experienced by 17.5% and 15% of the patients, respectively, acute nausea by 29.5%, and delayed nausea by 36.5%. The comparison of severity in acute vomiting between cycle 2 and cycle 3 yielded a statistically significant (p = 0.003) difference; similar results were obtained in the comparison of severity of acute nausea (p < 0.001). The correlation of severity of acute nausea with physical, emotional, and functional well-being as well as the total score of quality of life in two measurement points was statistically significant (p < 0.005). Multiple forward linear regression analysis showed that the total score of quality of life was significantly associated with age, gender, educational status, occupational status, type of cancer, family status, and diet.ConclusionsOur study confirms that nausea and vomiting are significant clinical problems that influence quality of life. Further research is needed to evaluate the predictors of acute and delayed nausea and vomiting during chemotherapy.

Benefits of ginger in the control of chemotherapy-induced nausea and vomiting.

To identify and discuss scientific evidence of the effects of ginger use on the management of chemotherapy-induced nausea and vomiting. This is an integrative reviewperformed by Ganong's reference. We included 24 studies, highlighting three thematic categories, namely 1) antiemetic action of ginger - nausea (13 articles; of these, nine significant) and emesis (10 studies; of these, six significant); 2) action in the control of nausea (11 articles; of these, six significant) and vomiting (8 articles; of these, three significant) in the acute phase; 3) action in the control of nausea (6 articles; of these, three significant) and vomiting (6 articles; of these, three significant) in the delayed phase. There were divergences of the methods used. This complementary therapy has low cost and easy access, but no statistical confirmation of its effectiveness in the management of nausea and vomiting in cancer patients was found.

Auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients: Perspectives from the traditional zang-fu organs and meridians theory

Auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients: Perspectives from the traditional zang-fu organs and meridians theory

419O - Olanzapine combined with 5-HT3 RA plus dexamethasone for prevention and treatment of chemotherapy-induced nausea and vomiting in cancer patients: A systematic review and meta-analysis of randomized controlled trials

BackgroundWe conducted a review to evaluate the efficacy and adverse events (AEs) of olanzapine combined with 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist (RA) plus dexamethasone compared with 5-HT3 RA plus dexamethasone for the prevention and treatment of chemotherapyinduced nausea and vomiting (CINV) in high and moderate emetogenic chemotherapy based on randomized controlled trials (RCTs). MethodsPubMed, Web of Science, EMBASE, and The Cochrane Library, WanFang Database, China Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Periodical Database (VIP) (inception to April 2019) were searched to recognize relevant articles. Relative risk (RR) with 95% confidence intervals (CIs) for CINV and AEs were all extracted. Results11 studies with 1107 cancer patients were involved in this review. The pooled RR of any level acute CINV (RR = 0.60, 95%CI: 0.48–0.75, Z=-4.57, P < 0.01) and any level delayed CINV (RR = 0.50, 95%CI: 0.38-0.66, Z=-4.87, P < 0.01) were significantly decreased in olanzapine group. While only CINV III and CINV IV were significantly decreased in olanzapine groups. Subgroup analysis indicated that there was no significant difference between 5mg and 10mg for olanzapine. Moreover, the occurrence of insomnia (RR = 0.12, 95%CI: 0.06-0.26, Z=-5.44, P < 0.01) was statistically decreased in the olanzapine group. ConclusionsOlanzapine significantly decreased the occurrence of moderate-severe CINV (CINV III and IV) and insomnia for the prevention and treatment of CINV in high and moderately emetogenic chemotherapy. Compared with 10mg per day, 5mg oral may be more appropriate for cancer patients. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

The Most Important Methods for Reducing Chemotherapy-Induced Nausea and Vomiting In Cancer Patients: A Systematic Review Study

Introduction: Despite the successes that have recently been made in the field of control and prevention of communicable diseases, the incidence of chronic illnesses has increased. And cancer as a chronic disease after accidents and unintentional deaths is the third leading cause of death in children. Given that cancer patients have multiple chemotherapy during their healing period and chemotherapy itself causes a lot of harm to the patient and that nausea and vomiting are a common complication in chemotherapy patients, Therefore, this systematic review was conducted to determine the most important methods for reducing the nausea and vomiting induced by chemotherapy in cancer patients.&#x0D; Materials and Methods: This study is a systematic review Using the articles published in the last 20 years, it was based on the most important methods for reducing the nausea and vomiting of chemotherapy in cancer patients. The search was carried out in search engines, SID, Magiran, and Google Scholar, Embase, ResearchGate, Sciencedirect, and PubMed in Persian and English. In the first stage, 47 articles were found. Of these, 10 related articles that have been published in the last 20 years have been reviewed.&#x0D; Results: In this study, we investigated the most important methods for reducing the nausea and vomiting of chemotherapy in cancer patients. In one of these studies, the rate of nausea and vomiting in patients undergoing chemotherapy was studied at the stage. In the first stage, without intervention, in the second phase, music was broadcast to patients using headphones. In the case of nausea, measurements with numerical criteria at 16 and 24 hours and descriptive criteria showed significant difference only at 24 hours after chemotherapy. However, there was no significant difference in vomiting between two stages of chemotherapy.&#x0D; Conclusion: According to the studied studies, ice massage in the Negan spot can be effective in reducing the frequency and severity of nausea and vomiting in cancer patients undergoing chemotherapy. It can also be said that muscle use reduces nausea in children with chemotherapy malignancy. It is suggested that nurses use ear acupressure technique as a complement to relieve nausea and vomiting caused by chemotherapy.

DESIGN, CHARACTERIZATION AND STATISTICAL OPTIMIZATION OF RAMOSETRON HYDROCHLORIDE MOUTH DISSOLVING FILM USING DESIGN OF EXPERIMENT

Objective: The present study aims to prepare a mouth dissolving film of ramosetron hydrochloride to provide relief to cancer patients suffering from nausea and vomiting.&#x0D; Methods: Mouth dissolving film of ramosetron hydrochloride were prepared and optimized using three levels two factor design. The films were prepared using the solvent casting technique. The effect of formulation variables such as the concentration of HPMC E15, and honey on disintegration time, tensile strength and drug release from the film were studied. The films were evaluated for weight, thickness, folding endurance, tensile strength, percent elongation, surface pH, disintegration time and drug release.&#x0D; Results: All the films were found to be transparent, non-sticky and easily peelable. The concentration of HPMC E 15 and Honey was found to have a significant effect on disintegration time and drug release of the mouth dissolving film. Formulation R1 was found to the best formulation with 104.21 % release in 9 min and disintegration time of 57 seconds.&#x0D; Conclusion: It can be concluded that the developed mouth dissolving film could serve as an effective, convenient alternative to prevent nausea and vomiting in cancer patients of any age group.