Chemotherapy-induced nausea and vomiting in routine practice: a European perspective

Agnes Glaus1 , Cornelia Knipping1, Rudolf Morant1, Christel Böhme2, Burkhard Lebert3, Frank Beldermann3, Bernhard Glawogger4, Paz Fernandez Ortega5, André Hüsler6 and Robert Deuson7

(1) Zentrum für Tumordiagnostik und Prävention (ZeTuP), Rorschacher Strasse 150, 9006 St. Gallen, Switzerland
(2) Department of Innere Medizin, Kantonsspital St. Gallen (KSSG), 9007 St. Gallen, Switzerland
(3) Universitätsklinikum Heidelberg Fachweiterbildung, Im Neuenheimer Feld 105, 69120 Heidelberg, Germany
(4) LKH-Universitätsklinikum, Medizinische Universitätsklinik, Auenbruggerplatz 15, 8036 Graz, Austria
(5) Institut Catala Oncologia ICO, Av. Castelldefels s/n/km 2, 7 lHospitalet., 08907 Barcelona, Spain
(6) Institut für mathematische Statistik und Versicherungslehre, Universität Bern, Sidlerstrasse 5, 3012 Bern, Switzerland
(7) Merck & Co., Inc., One Merck Drive, PO Box 100 (WS2E-76), Whitehouse Station, NJ 08889, USA

Received: 7 December 2003 Accepted: 27 May 2004 Published online: 24 July 2004

Abstract
Goals of work The aim of this study was to evaluate the occurrence of chemotherapy-induced nausea and vomiting (CINV) and its effect on patients ability to carry out daily life activities following moderately to highly emetogenic, first-cycle chemotherapy in routine practice in cancer centers of four different European countries.
Patients and methods This was a prospective, cross-sectional, nonrandomized, self-assessment study in 249 patients enrolled from cancer centers in Spain, Austria, Germany, and Switzerland. The study population consisted of 78% women, with a mean age of 54. Breast, lung, and ovarian cancers made up 75% of all cancers in the study. Patients received a mean of 2.0 chemotherapy agents and 2.5 antiemetic drugs.
Main results A total of 450 emetic episodes experienced by 243 patients was recorded over 5 days following chemotherapy, with an average of 1.8 episodes per patient (range: 0–28). A higher percentage of patients (38%) suffered from delayed compared to acute emesis (13%). Between 42% and 52% of all patients suffered from nausea (visual analogue scale 5 mm) on any one day, peaking at day 3. Using the Functional Living Index for Emesis (FLIE) questionnaire, 75% of patients with nausea and 50% with vomiting reported a negative impact of these conditions on performance of daily living.
Conclusions CINV remains a significant problem in routine practice, particularly in the delayed phase posttreatment. Overall, CINV had a negative impact on patients daily life.
Keywords Nausea/emesis - Cancer treatment - Antiemetic therapy - Patient-reported outcomes


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