Poor chemotherapy-induced nausea and vomiting control in children receiving intermediate or high dose methotrexate.
Support Care Cancer
; 24(3): 1365-71, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26335406
ABSTRACT
PURPOSE:
Chemotherapy emetogenicity is the most important known determinant of chemotherapy-induced vomiting (CIV) in children. However, direct evidence regarding the emetogenic potential of chemotherapeutic agents in children is limited. This study describes the prevalence of complete control of acute and delayed phase chemotherapy-induced nausea and vomiting (CINV) in children receiving methotrexate. The prevalence of anticipatory CINV is described, and risk factors for CINV are explored.METHODS:
English-speaking children (4 to 18 years) receiving intermediate-dose (ID-MTX >1 to <12 g/m(2)/dose) or high-dose methotrexate (HD-MTX ≥12 g/m(2)/dose) participated in this prospective study. Emetic episodes, nausea severity, and antiemetic administration were documented for 24 h from the start of the methotrexate infusion (acute phase) and for up to a further 168 h (delayed phase). CINV prophylaxis was provided at the discretion of the treating physician. Anticipatory CINV was assessed in the 24 h preceding chemotherapy. Complete CINV control was defined as no emetic episodes and no nausea.RESULTS:
Thirty children (mean age, 11.8 ± 4 years; ID-MTX, 20; HD-MTX, 10) completed the study. CINV prophylaxis included the following ondansetron/granisetron plus dexamethasone or nabilone. Few patients experienced complete CINV control (ID-MTX acute phase 20%, delayed phase 5%; HD-MTX acute phase 0%, delayed phase 30%). Complete emesis control was higher (ID-MTX acute phase 70%, delayed phase 50%; HD-MTX acute phase 70%, delayed phase 60%). Anticipatory CINV was reported by 6/28 patients (21%). Patient age, sex, and history of motion sickness were not significant predictors of CINV.CONCLUSIONS:
The poor complete CINV control rate in children receiving methotrexate confirms the classification of HD-MTX as highly emetogenic chemotherapy (HEC) and suggests that ID-MTX be reclassified as HEC.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vômito
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Metotrexato
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Antieméticos
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Náusea
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Antimetabólitos Antineoplásicos
/
Antineoplásicos
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article