A prospective observational trial on emesis in radiotherapy: Analysis of 1020 patients recruited in 45 Italian radiation oncology centres

Ernesto Maranzano, Verena De Angelis, Stefano Pergolizzi, Marco Lupattelli, Paolo Frata, Stefano Spagnesi, Maria Luisa Frisio, Giovanni Mandoliti, Giuseppe Malinverni, Fabio Trippa, Letizia Fabbietti, Salvatore Parisi, Annamaria Di Palma, Pietro De Vecchi, Costantino De Renzis, Celestino Giorgetti, Tiziano Bergami, Roberto Orecchia, Maurizio Portaluri, Marco SignorDavide Di Gennaro

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Abstract

Purpose: A prospective observational multicentre trial was carried out to assess the incidence, pattern, and prognostic factors of radiation-induced emesis (RIE), and to evaluate the use of antiemetic drugs in patients treated with radiotherapy or concomitant radio-chemotherapy. The application in clinical practice of the Multinational Association of Supportive Care in Cancer guidelines was also studied. Materials and methods: Forty-five Italian radiation oncology centres took part in this trial. The accrual lasted for 3 consecutive weeks and only patients starting radiotherapy or concomitant radio-chemotherapy in this period were enrolled. Evaluation was based on diary card filled in daily by patients during treatment and one week after stopping it. Diary card recorded the intensity of nausea/vomiting and prophylactic/symptomatic antiemetic drug prescriptions. Results: A total of 1020 patients entered into the trial, and 1004 were evaluable. Vomiting and nausea occurred in 11.0% and 27.1% of patients, respectively, and 27.9% patients had both vomiting and nausea. In multifactorial analysis, the only statistically significant patient-related risk factors were concomitant chemotherapy and previous experience of vomiting induced by chemotherapy. Moreover, two radiotherapy-related factors were significant risk factors for RIE, the irradiated site (upper abdomen) and field size (>400 cm2). An antiemetic drug was given only to a minority (17%) of patients receiving RT, and the prescriptions were prophylactic in 12.4% and symptomatic in 4.6%. Different compounds and a wide range of doses and schedules were used. Conclusions: These data were similar to those registered in our previous observational trial, and the radiation oncologists' attitude in underestimating RIE and under prescribing antiemetics was confirmed.

Original languageEnglish
Pages (from-to)36-41
Number of pages6
JournalRadiotherapy and Oncology
Volume94
Issue number1
DOIs
Publication statusPublished - Jan 2010

Fingerprint

Radiation Oncology
Vomiting
Radiotherapy
Antiemetics
Nausea
Drug Therapy
Radiation
Radio
Drug Prescriptions
Abdomen
Multicenter Studies
Prescriptions
Appointments and Schedules
Guidelines
Incidence

Keywords

  • Drug utilization review of antiemetics
  • Nausea
  • Radiation-induced emesis
  • Vomiting

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

A prospective observational trial on emesis in radiotherapy : Analysis of 1020 patients recruited in 45 Italian radiation oncology centres. / Maranzano, Ernesto; De Angelis, Verena; Pergolizzi, Stefano; Lupattelli, Marco; Frata, Paolo; Spagnesi, Stefano; Frisio, Maria Luisa; Mandoliti, Giovanni; Malinverni, Giuseppe; Trippa, Fabio; Fabbietti, Letizia; Parisi, Salvatore; Di Palma, Annamaria; De Vecchi, Pietro; De Renzis, Costantino; Giorgetti, Celestino; Bergami, Tiziano; Orecchia, Roberto; Portaluri, Maurizio; Signor, Marco; Di Gennaro, Davide.

In: Radiotherapy and Oncology, Vol. 94, No. 1, 01.2010, p. 36-41.

Research output: Contribution to journalArticle

Maranzano, E, De Angelis, V, Pergolizzi, S, Lupattelli, M, Frata, P, Spagnesi, S, Frisio, ML, Mandoliti, G, Malinverni, G, Trippa, F, Fabbietti, L, Parisi, S, Di Palma, A, De Vecchi, P, De Renzis, C, Giorgetti, C, Bergami, T, Orecchia, R, Portaluri, M, Signor, M & Di Gennaro, D 2010, 'A prospective observational trial on emesis in radiotherapy: Analysis of 1020 patients recruited in 45 Italian radiation oncology centres', Radiotherapy and Oncology, vol. 94, no. 1, pp. 36-41. https://doi.org/10.1016/j.radonc.2009.11.001
Maranzano, Ernesto ; De Angelis, Verena ; Pergolizzi, Stefano ; Lupattelli, Marco ; Frata, Paolo ; Spagnesi, Stefano ; Frisio, Maria Luisa ; Mandoliti, Giovanni ; Malinverni, Giuseppe ; Trippa, Fabio ; Fabbietti, Letizia ; Parisi, Salvatore ; Di Palma, Annamaria ; De Vecchi, Pietro ; De Renzis, Costantino ; Giorgetti, Celestino ; Bergami, Tiziano ; Orecchia, Roberto ; Portaluri, Maurizio ; Signor, Marco ; Di Gennaro, Davide. / A prospective observational trial on emesis in radiotherapy : Analysis of 1020 patients recruited in 45 Italian radiation oncology centres. In: Radiotherapy and Oncology. 2010 ; Vol. 94, No. 1. pp. 36-41.
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T2 - Analysis of 1020 patients recruited in 45 Italian radiation oncology centres

AU - Maranzano, Ernesto

AU - De Angelis, Verena

AU - Pergolizzi, Stefano

AU - Lupattelli, Marco

AU - Frata, Paolo

AU - Spagnesi, Stefano

AU - Frisio, Maria Luisa

AU - Mandoliti, Giovanni

AU - Malinverni, Giuseppe

AU - Trippa, Fabio

AU - Fabbietti, Letizia

AU - Parisi, Salvatore

AU - Di Palma, Annamaria

AU - De Vecchi, Pietro

AU - De Renzis, Costantino

AU - Giorgetti, Celestino

AU - Bergami, Tiziano

AU - Orecchia, Roberto

AU - Portaluri, Maurizio

AU - Signor, Marco

AU - Di Gennaro, Davide

PY - 2010/1

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N2 - Purpose: A prospective observational multicentre trial was carried out to assess the incidence, pattern, and prognostic factors of radiation-induced emesis (RIE), and to evaluate the use of antiemetic drugs in patients treated with radiotherapy or concomitant radio-chemotherapy. The application in clinical practice of the Multinational Association of Supportive Care in Cancer guidelines was also studied. Materials and methods: Forty-five Italian radiation oncology centres took part in this trial. The accrual lasted for 3 consecutive weeks and only patients starting radiotherapy or concomitant radio-chemotherapy in this period were enrolled. Evaluation was based on diary card filled in daily by patients during treatment and one week after stopping it. Diary card recorded the intensity of nausea/vomiting and prophylactic/symptomatic antiemetic drug prescriptions. Results: A total of 1020 patients entered into the trial, and 1004 were evaluable. Vomiting and nausea occurred in 11.0% and 27.1% of patients, respectively, and 27.9% patients had both vomiting and nausea. In multifactorial analysis, the only statistically significant patient-related risk factors were concomitant chemotherapy and previous experience of vomiting induced by chemotherapy. Moreover, two radiotherapy-related factors were significant risk factors for RIE, the irradiated site (upper abdomen) and field size (>400 cm2). An antiemetic drug was given only to a minority (17%) of patients receiving RT, and the prescriptions were prophylactic in 12.4% and symptomatic in 4.6%. Different compounds and a wide range of doses and schedules were used. Conclusions: These data were similar to those registered in our previous observational trial, and the radiation oncologists' attitude in underestimating RIE and under prescribing antiemetics was confirmed.

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KW - Radiation-induced emesis

KW - Vomiting

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