A prospective observational study on chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer by the CINV Study Group of Japan

• This study was the largest series of gynecologic cancer patients to examine the CINV.
• Generalized linear mixed models showed that the peak of nausea occurred from days 3 to 5.
• The risk significant factor for CINV was morning sickness despite chemotherapy regimen.

ObjectiveThis study was performed to investigate the occurrence of and risk factors for chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer.MethodsIn total, 214 patients with gynecologic cancer who underwent highly emetogenic (HEC) or moderately emetogenic chemotherapy (MEC) were evaluated. We investigated the relationship between CINV and clinical factors and the accuracy of estimation of CINV by medical staff in the acute and late phases. Vomiting was evaluated in terms of frequency, and nausea was evaluated with a 100-mm visual analog scale on days 1 to 7. We also analyzed the risk factors and changes in CINV over time using a generalized linear mixed (GLM) model.ResultsThe multivariate analysis revealed no significant risk factors for acute CINV. The independent risk factors for delayed nausea were a morning sickness history (odds ratio [OR], 2.687; 95% confidence interval [95% CI], 1.450–4.976; p = 0.0017), age (each 1-year increment) (OR, 0.97; 95% CI, 0.944–0.996; p = 0.0235), and HEC (OR, 2.134; 95% CI, 1.039–4.383; p = 0.0391). The GLM model demonstrated that the independent factors affecting nausea were significant morning sickness (p = 0.0101) and HEC (p = 0.0136). These data also showed more severe nausea from days 3 to 5, but the negative predictive value for estimation of delayed nausea by medical staff was 57.8%.ConclusionOur data suggest that improvement of preventive antiemetic administration is needed for patients with risk factors to manage delayed CINV caused by HEC and by MEC.