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A prospective study of gastrointestinal radiation therapy-induced nausea and vomiting

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Abstract

Objective

Nausea and vomiting are common side effects from radiotherapy that can interfere with gastrointestinal (GI) cancer patients’ quality of life (QOL). A prospective study among patients with GI cancers was conducted to document the timing, incidence and risk factors of radiation therapy-induced nausea and vomiting (RINV).

Methods

Forty-eight patients planned to receive curative or palliative intent abdominal and/or pelvic radiotherapy alone or with concomitant chemoradiotherapy were followed prospectively. All episodes of nausea, vomiting, retching and antiemetic use were recorded daily for the entire treatment period and for the week following completion of therapy. QOL was assessed weekly using the Functional Living Index—Emesis Quality of Life Tool and the EORTC QLQ-C30 core questionnaire.

Results

Nausea occurred in 83 % of patients and emesis in 54 %. Pancreatic cancer was significantly correlated to higher proportions of nausea and emesis (p = 0.002 and p = 0.0003) compared to other primary sites. There were no significant difference between concomitant chemoradiotherapy and radiotherapy only patients for nausea and emesis. Patients had significantly greater proportions of RINV during the first, second and fifth weeks of treatment and during the first week following treatment. Vomiting was found to impair patients’ usual recreation or leisure activities and enjoyment of their meals. Worse physical, role and social functioning and greater fatigue and appetite loss over the course of treatment correlated directly with the timing of RINV symptoms.

Conclusion

RINV worsened QOL and was experienced even after treatment was completed; physicians should therefore be cognizant and monitor patients in the week following radiotherapy. Concomitant chemoradiotherapy should potentially be included in the moderate emetogenic risk category.

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Acknowledgements

We thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund and Ofelia Cancer Research Fund.

Conflict of interest

None.

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Authors and Affiliations

  1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    Michael Poon, Carlo DeAngelis, Hans Chung, Jordan Stinson, Liying Zhang, Gillian Bedard, Marko Popovic, Nicholas Lao, Natalie Pulenzas, Shun Wong & Edward Chow

  2. Division of Radiation Oncology, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

    Kristopher Dennis

  3. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada, M4N 3M5

    Edward Chow

Authors
  1. Michael Poon
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  2. Kristopher Dennis
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  3. Carlo DeAngelis
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  4. Hans Chung
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  5. Jordan Stinson
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  6. Liying Zhang
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  7. Gillian Bedard
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  8. Marko Popovic
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  9. Nicholas Lao
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  10. Natalie Pulenzas
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  11. Shun Wong
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  12. Edward Chow
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Corresponding author

Correspondence to Edward Chow.

Appendices

Appendices

Appendix I. FLIE

figure afigure a

Appendix II. EORTC C30

figure b

Appendix III

Table 5 QOL in patients receiving radiotherapy for gastrointestinal cancer as assessed by the QLQ-C30 and FLIE
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Poon, M., Dennis, K., DeAngelis, C. et al. A prospective study of gastrointestinal radiation therapy-induced nausea and vomiting. Support Care Cancer 22, 1493–1507 (2014). https://doi.org/10.1007/s00520-013-2104-0

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  • DOI: https://doi.org/10.1007/s00520-013-2104-0

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