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Prophylaxis of radiotherapy-induced nausea and vomiting in the palliative treatment of bone metastases

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Abstract

Purpose

To document the incidence and timing of radiotherapy-induced nausea and vomiting (RINV) in the treatment of bone metastases among patients receiving prophylaxis with a 5-HT3 receptor antagonist.

Methods

Patients receiving single (SF) or multiple fraction (MF) palliative radiotherapy (RT) of moderate or low emetogenic risk for bone metastases were prescribed prophylactic Ondansetron. The frequency and duration of prophylaxis and the use of rescue antiemetics were left to the discretion of the treating physicians. Patients documented episodes of nausea (N) and vomiting (V) in daily diaries before and during RT, and until 10 days following RT completion. Rates of complete prophylaxis (CP) for N&V, respectively (CP = no event and no rescue medication), were calculated for the acute phase (the period from the start of RT to the first day following RT completion inclusive) and the delayed phase (the second to tenth days following RT completion inclusive).

Results

Fifty-nine patients were enrolled, and 32 were evaluable. CP rates were as follows: moderate-risk SF group (n = 16), acute phase (CP for N = 56%, CP for V = 69%) and delayed phase (CP for N = 31%, CP for V = 44%); moderate-risk MF group (n = 7), acute phase (CP for N = 71%, CP for V = 57%) and delayed phase (CP for N = 43%, CP for V = 57%); low-risk SF group (n = 8), acute phase (CP for N = 50%, CP for V = 100%) and delayed phase (CP for N = 43%, CP for V = 57%); and low-risk MF group (n = 1), acute phase (CP for N = 100%, CP for V = 100%) and delayed phase (CP for N = 100%, CP for V = 100%).

Conclusions

Despite prophylaxis, RINV was common among patients receiving palliative radiotherapy for bone metastases, especially during the delayed phase.

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Acknowledgments

Kristopher Dennis is supported in this work by a Canadian Institutes of Health Research (CIHR) Fellowship Award. This study was generously supported by the Michael and Karyn Goldstein Cancer Research Fund. The authors thank Mrs. Stacy Yuen and Ms. Kristina Facchini for their administrative assistance.

Conflicts of interest

None to declare.

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Authors and Affiliations

  1. Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Kristopher Dennis, Janet Nguyen, Roseanna Presutti, Carlo DeAngelis, May Tsao, Cyril Danjoux, Elizabeth Barnes, Arjun Sahgal, Lori Holden, Florencia Jon, Shun Wong & Edward Chow

  2. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada, M4N3M5

    Edward Chow

Authors
  1. Kristopher Dennis
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  2. Janet Nguyen
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  3. Roseanna Presutti
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  4. Carlo DeAngelis
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  5. May Tsao
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  6. Cyril Danjoux
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  7. Elizabeth Barnes
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  8. Arjun Sahgal
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  9. Lori Holden
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  10. Florencia Jon
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  11. Shun Wong
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  12. Edward Chow
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Corresponding author

Correspondence to Edward Chow.

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Dennis, K., Nguyen, J., Presutti, R. et al. Prophylaxis of radiotherapy-induced nausea and vomiting in the palliative treatment of bone metastases. Support Care Cancer 20, 1673–1678 (2012). https://doi.org/10.1007/s00520-011-1258-x

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  • DOI: https://doi.org/10.1007/s00520-011-1258-x

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