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Prevention of chemotherapy‐induced vomiting in children receiving multiple‐day cisplatin chemotherapy: A hospital‐based, retrospective cohort study
Author(s) -
Kishimoto Kenji,
Kawasaki Keiichiro,
Saito Atsuro,
Kozaki Aiko,
Ishida Toshiaki,
Hasegawa Daiichiro,
Kosaka Yoshiyuki
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26485
Subject(s) - medicine , chemotherapy , vomiting , incidence (geometry) , odds ratio , retrospective cohort study , confidence interval , dexamethasone , surgery , optics , physics
Background Optimal prevention of chemotherapy‐induced vomiting (CIV) has not been established for patients receiving cisplatin in divided doses. The aim of this study was to describe the incidence and risk factors of CIV in children who received multiple‐day cisplatin chemotherapy. Procedure A total of 24 consecutive pediatric patients (age 0–19 years) who received multiple‐day cisplatin chemotherapy in our hospital were enrolled. Patients with relapsed disease or primary intracranial tumor and those who received concurrent radiation therapy were excluded. The number of chemotherapy cycles reviewed was 107, with a median of five per patient. All patients received granisetron. Dexamethasone and NK‐1 receptor antagonists (NK1RA) were used as additional antiemetics for prophylaxis of CIV. Results CIV was observed in 22 of 24 (92%) patients, and 61 of 107 (57%) cycles. Patients who developed CIV had a higher incidence of other chemotherapy‐related adverse events (87 vs. 41%, P < 0.001). The incidence of CIV was lower in patients administered with NK1RA than those without (32 vs. 68%, P < 0.001). Multivariate logistic regression identified age less than or equal to 2 years (odds ratio [OR] = 0.25, 95% confidence interval [CI] = 0.10–0.63) and administration of NK1RA (OR = 0.16, 95% CI = 0.06–0.43) as independent factors for CIV. Conclusions These results suggest that NK1RA is crucial to reduce CIV in children who receive multiple‐day cisplatin chemotherapy.