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Prognostic factors influencing cisplatin‐induced emesis. Definition and validation of a predictive logistic model
Author(s) -
Pollera Camillo F.,
Giannarelli Diana
Publication year - 1989
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19890901)64:5<1117::aid-cncr2820640525>3.0.co;2-r
Subject(s) - medicine , antiemetic , metoclopramide , regimen , vomiting , logistic regression , nausea , anesthesia
Abstract Data obtained from 209 patients who entered different prospective randomized antiemetic trials were analyzed to establish the prognostic value of some variables on the control of cisplatin‐induced emesis. The antiemetic regimens evaluated included the following: metoclopramide (M) at 1, 2, and 4 mg/kg total dose and a combination of M (4 mg/kg) with dexamethasone (D) (40 mg). Vomiting lasting more than I hour (no protection [NP]) was the endpoint selected for the analysis. A logistic model carried out, first on the 110 subjects receiving the M + D regimen and then on the whole sample, selected sex ( P = 0.0001), Eastern Cooperative Oncology Group performance status (PS) ( P = 0.006), and age ( P = 0.01) among the six factors considered. Since the prognostic value of these variables is mostly related to their interaction, three major risk classes were identified. The corresponding NP rates were 26.3%, 42.4%, and 70.8% for the low‐risk, intermediate‐risk, and high‐risk groups, respectively ( P = 0.2). Except for the lowest M level, the observed NP rates were significantly associated to the risk classes, whereas the antiemetic regimen influenced the antiemetic outcome only in the low‐risk class. Regardless of the regimen employed, certain patient characteristics, such as sex, PS, and age, significantly affect cisplatin‐related emesis and should be carefully considered in planning further studies.