Prevention and treatment of anticipatory chemotherapy‐induced nausea and vomiting in pediatric cancer patients and hematopoietic stem cell recipients: Clinical practice guideline update

Patel, Priya; Robinson, Paula D.; Devine, Katie A.; Positano, Karyn; Cohen, Marie; Gibson, Paul; Holdsworth, Mark T.; Phillips, Bob; Spinelli, Daniela; Thackray, Jennifer; Wetering, Marianne van de; Woods, Deborah; Cabral, Sandra; Sung, Lillian; Dupuis, L. Lee

doi:10.1002/pbc.28947

Cited by 22 publications

(22 citation statements)

References 43 publications

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“…Aromatherapy is an effective method to manage POV (26). Systematic desensitization, hypnosis, relaxation techniques, and lorazepam can be considered for the prevention of CINV (12). Numerous therapies are free or cheap, making them a convenient adjunct to medication.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the differences in chemotherapy doses and regimens between children and adults, the risk factors of CINV in children may also be different from adults (11). The 2021 clinical practice guideline is strongly recommended to optimize acute and delayed CINV control to prevent anticipatory CINV (12). In the first 24 hours, the complete control rate of highly emetic chemotherapy (HEC) in pediatric patients was 37% and that of MEC in such patients was 24% (5).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study

Zeng¹,

Chen²,

Xu³

et al. 2021

Transl Pediatr

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Background: The chemotherapy-induced vomiting (CIV) severely affects the daily function, nutritional status, treatment compliance, therapeutic efficacy, curability, and the quality of life of patients. The aim of this study was to find the risk factors for CIV after general anesthesia in patients with retinoblastoma (RB).Methods: A retrospective review of the hospital records of children with RB, who underwent chemotherapy between January 2017 and December 2019, was conducted at our hospital.Results: Data of a total of 803 children with RB were reviewed. The incidence of CIV in children with RB was 19.30%. Univariate analysis showed statistically significant differences in age, height, weight, chemotherapy regimen, anesthesia dose, duration of surgery and general anesthesia, platelet count, platelet distribution width, lymphocytes, and indirect bilirubin between patients with and without vomiting (P<0.05).Multivariate logistic regression analysis showed that the main predictors of CIV in children with RB included older age [odds ratio (OR), 1.32; 95% confidence interval (CI): 1.11-1.56; P<0.01], low platelet count (OR, 0.997; 95% CI: 0.995-0.999; P<0.05), and chemotherapy regimen (intravenous chemotherapy versus intraarterial chemotherapy; OR, 0.47; 95% CI: 0.29-0.76; P<0.01).Conclusions: This study revealed age, chemotherapy regimen, and platelet count as risk factors of CIV after general anesthesia in children with RB. Younger age and higher platelet count were protective factors for CIV. Compared with intravenous chemotherapy, the incidence of CIV was lower than that of intraarterial chemotherapy. Although these factors cannot be modified, they can predict whether a patient may experience vomiting, assisting medical staff to formulate measures and intervenes in advance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study

Zeng¹,

Chen²,

Xu³

et al. 2021

Transl Pediatr

View full text Add to dashboard Cite

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“…Lorazepam can be considered to prevent anticipatory CINV, but the evidence guiding this recommendation is weak and the optimal paediatric dose is not established. 6 Some data indicate that cannabinoids are of therapeutic value in the control of CINV in children, but no paediatric trials compare the efficacy and safety of cannabinoids with modern first-line antiemetic therapy. 10…”

Section: Additional Optionsmentioning

confidence: 99%

“…POGO has developed guidelines for breakthrough, refractory, and anticipatory CINV in children, but the recommendations within these guidelines are generally weak. 5,6 No paediatric guideline includes antiemetic strategies for delayed CINV or multiday chemotherapy regimens.…”

Section: Adherence To Available Antiemetic Guidelinesmentioning

confidence: 99%

“…CINV is classified as acute, delayed, anticipatory, breakthrough, and refractory, depending on the time of onset in relation to chemotherapy administration and on patients' response to previous antiemetic prophylaxis. 2,5,6 Anticipatory CINV occurs before chemotherapy administration; acute CINV in the first 24 h after chemotherapy administration; delayed CINV from 24h and up to 1 week after chemotherapy administration; breakthrough CINV within 1 week after chemotherapy administration despite appropriate antiemetic prophylaxis, and refractory CINV occurs in subsequent chemotherapy cycles despite changes in antiemetic prophylaxis.…”

Section: Background Of Chemotherapy-induced Nausea and Vomitingmentioning

confidence: 99%

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Chemotherapy-induced nausea and vomiting in children – the missing evidence

Eliasen

Schmiegelow

Rechnitzer

et al. 2021

Adverse Drug Reaction Bulletin

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Chemotherapy-induced nausea and vomiting (CINV) is a devastating adverse effect associated with treatment of childhood cancer that can lead to disruption of normal childhood activities and delay in important treatment with oral medicaments. Guidelines have been developed by several cancer associations helping clinicians to select proper antiemetic prophylaxis. [1][2][3][4] Generally, 5-hydroxytryptamine type 3 (5-HT 3 ) receptor antagonists, neurokinin 1 (NK 1 ) receptor antagonists, and dexamethasone are recommended to prevent CINV in children. The evidence directing these guidelines is limited by lack of available paediatric studies, and CINV control remains therefore often suboptimal for patients and a clinical challenge for healthcare professionals. However, emerging paediatric data are available in this increasingly popular research area, and newer antiemetic drugs, including olanzapine and lorazepam, may improve the CINV control.In this review, we provide information on the missing evidence in prevention and treatment of CINV in children, discuss barriers to use the available guidelines, and highlight areas for further research.

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New persistent opioid use among adolescents and young adults with sarcoma

Beauchemin

Raghunathan

Accordino

et al. 2022

Cancer

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BACKGROUND: Adolescents and young adults (AYA) with sarcoma experience both acute and chronic pain related to their disease and treatment. Studies in older adults have reported a high risk of persistent opioid use after cancer therapy among previously opioid-naive patients; however, few studies have evaluated posttreatment opioid use among AYAs. This article describes patterns of new persistent opioid use among AYAs in the year after treatment for sarcoma. METHODS: Opioid-naive patients who were 10 to 26 years old and diagnosed with sarcoma (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) were identified with the IBM Marketscan Database. Included subjects had an International Classification of Diseases code for sarcoma (ninth or tenth revision), received anticancer therapy (chemotherapy, surgery, and/or radiation) within 30 days of the first diagnosis code, and had continuous insurance coverage (commercial or Medicaid) for more than 12 months both before the diagnosis and after the last therapy. The primary outcome was new persistent opioid use, which was defined as at least 2 opioid prescriptions in the 12 months following treatment completion. Covariates included age, sex, insurance, tumor type, surgical procedure, mental health (MH) or substance use diagnoses before or during therapy, and concomitant lorazepam use. RESULTS: In total, 938 patients met the inclusion criteria; 521 (56%) were male, and 578 (62%) were younger than 18 years. In total, 727 (78%) had commercial insurance, and 273 (29%) had an MH diagnosis either before or during the treatment period. Of the total group, 464 (49%) used opioids during treatment only. Of those who used opioids during treatment, 135 (23%) received at least 2 prescriptions in the year after therapy. In a multivariable analysis, Medicaid versus commercial insurance (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.15-2.64) and non-soft tissue sarcoma (OR for Ewing sarcoma, 3.23; 95% CI, 1.81-5.78; OR for osteosarcoma, 2.05; 95% CI, 1.36-3.09) conferred a higher likelihood of new persistent use. CONCLUSIONS: In this cohort of AYAs treated for sarcoma, 64% of the patients received opioid prescriptions during treatment, and 23% of these patients became new persistent users. Because of the risks associated with persistent opioid use, studies of novel pain management strategies along with age-appropriate education and anticipatory guidance are urgently needed.

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Prevention and treatment of anticipatory chemotherapy‐induced nausea and vomiting in pediatric cancer patients and hematopoietic stem cell recipients: Clinical practice guideline update

Cited by 22 publications

References 43 publications

Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study

Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study

Chemotherapy-induced nausea and vomiting in children – the missing evidence

New persistent opioid use among adolescents and young adults with sarcoma

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