Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes

Singh, Komal; Kober, Kord M.; Dhruva, Anand; Flowers, Elena; Paul, Steve M; Hammer, Marilyn J.; Cartwright, Frances; Wright, Fay; Conley, Yvette P.; Levine, Jon D.; Miaskowski, Christine

doi:10.1016/j.jpainsymman.2018.05.019

Cited by 15 publications

(13 citation statements)

References 52 publications

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“…MAX2 scores, 36,37 emetogenicity of the chemotherapy regimen, and antiemetic regimens were calculated as previously described. 38 Differences in demographics and clinical and symptom characteristics between patients who did and did not report CFT were evaluated using Independent sample t-tests, Chi-Square analyses, and Mann-Whitney U tests. To evaluate the association between select phenotypic and symptom characteristics and CFT group membership, a backwards, stepwise logistic regression analysis was performed.…”

Section: Discussionmentioning

confidence: 99%

Co-occurring Gastrointestinal Symptoms Are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy

Nolden

Joseph

Kober

et al. 2019

Journal of Pain and Symptom Management

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Context. Over 80% of patients with cancer report taste changes. Despite the high prevalence of this symptom and its negative effects on health, few studies have assessed its association with other gastrointestinal (GI) symptoms.Objectives. Determine the occurrence, frequency, severity, and distress of patient-reported ''change in the way food tastes'' (CFT) and identify phenotypic and GI symptoms characteristics associated with its occurrence.Methods. Patients receiving chemotherapy for breast, GI, gynecological, or lung cancer completed demographic and symptom questionnaires prior to their second or third cycle of chemotherapy. CFT was assessed using the Memorial Symptom Assessment Scale. Differences in demographic, clinical, and GI symptom characteristics were evaluated using parametric and nonparametric tests.Results. Of the 1329 patients, 49.4% reported experiencing CFT in the week prior to their second or third cycle of chemotherapy. In the univariate analysis, patients who reported CFT had fewer years of education; were more likely to be black or Hispanic, mixed race, or other; and had a lower annual household income. A higher percentage of patients with CFT reported the occurrence of 13 GI symptoms (e.g., constipation, diarrhea, abdominal cramps, feeling bloated). In a multivariable logistic regression analysis, compared with patients with breast cancer, patients with lung cancer (odds ratio ¼ 0.55; P ¼ 0.004) had a decrease in the odds of being in the CFT group. Patients who received a neurokinin-1 receptor antagonist and two other antiemetics were at an increased odds of being in the CFT group (odds ratio ¼ 2.51; P ¼ 0.001). Eight of the 13 GI symptoms evaluated were associated with an increased odds of being in the CFT group.Conclusions. This study provides new evidence on the frequency, severity, and distress of CFT in oncology patients undergoing chemotherapy. These findings suggest that CFT is an important problem that warrants ongoing assessments and nutritional interventions.

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Section: Discussionmentioning

confidence: 99%

Co-occurring Gastrointestinal Symptoms Are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy

Nolden

Joseph

Kober

et al. 2019

Journal of Pain and Symptom Management

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“…While antiemetic prophylaxis controls vomiting, persistent CIN remains a significant clinical problem (Roila et al, 2016). In our recent study (Singh, Kober, et al, 2018), 48% of the patients reported CIN prior to their second or third cycle of CTX. Findings from 2 studies suggest that CIN could be the sentinel symptom for the occurrence and severity of a wide array of CTX-induced symptoms (Donovan et al, 2016; Papachristou et al, 2019).…”

mentioning

confidence: 83%

“…This study is part of a larger, longitudinal study, of the symptom experience of oncology outpatients receiving CTX whose details are published elsewhere (Miaskowski et al, 2014; Singh, Kober, et al, 2020; Singh, Paul, et al, 2020; Singh, Dhruva, et al, 2020; Singh, Kober, et al, 2018; Wright et al, 2015). Eligible patients were ≥ 18 years of age; had a diagnosis of breast, GI, gynecological (GYN), or lung cancer; had received CTX within the preceding 4 weeks; were scheduled to receive at least two additional cycles of CTX; were able to read, write, and understand English; and gave written informed consent.…”

Section: Methodsmentioning

confidence: 99%

Perturbations in Endocytotic and Apoptotic Pathways Are Associated With Chemotherapy-Induced Nausea

Singh

Cao

Miaskowski

et al. 2020

Biological Research For Nursing

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Background: While vomiting is well controlled with current antiemetic regimens, unrelieved chemotherapy-induced nausea (CIN) is a significant clinical problem. Perturbations in endocytotic and apoptotic pathways in the gut can influence the functioning of the microbiome-gut-brain-axis and the occurrence of gastrointestinal (GI) symptoms. However, limited information is available on the mechanisms that underlie unrelieved CIN. Objectives: The purpose of this study was to evaluate for perturbed biological pathways associated with endocytosis and apoptosis in oncology patients who did (n = 353) and did not (n = 275) report CIN prior to their second or third cycle of chemotherapy (CTX). Methods: Oncology patients (n = 735) completed study questionnaires in the week prior to their second or third cycle of CTX. CIN occurrence was evaluated using the Memorial Symptom Assessment Scale. Pathway impact analyses (PIA) were performed in 2 independent samples using RNA-sequencing (sample 1, n = 334) and microarray (sample 2, n = 294) methodologies. Fisher’s combined probability method was used to identify signaling pathways related to endocytotic and apoptotic mechanisms that were significantly perturbed between the 2 nausea groups across both samples. Results: CIN was reported by 63.6% of the patients in sample 1 and 48.9% of the patients in sample 2. Across the 2 samples, PIA identified 4 perturbed pathways that are involved in endocytosis (i.e., endocytosis, regulation of actin cytoskeleton) and apoptosis (i.e., apoptosis, PI3K/Akt signaling). Conclusions: Our findings suggest that CTX-induced inflammation of the GI mucosa, that results in the initiation of endocytotic and apoptotic processes in the gut, is associated with the occurrence of CIN.

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“…Entre os sintomas gastrointestinais, os mais citados neste estudo foram: empachamento (56,0%), xerostomia (54,0%), inapetência (42,0%) e náusea (37,0%). Contudo, outros estudos observaram diferentes sintomas como os mais prevalentes: constipação e diarreia (58,3%) 16 e náusea (47,5%) 21 . Ressalta-se ainda que, além dos efeitos adversos oriundos dos quimioterápicos, quase 35,0% dos participantes deste estudo apresentavam câncer no trato gastrointestinal, fator este que também contribuiu para o surgimento de sintomas relacionados ao sistema digestivo.…”

Section: Métodounclassified

Estado Nutricional e Sintomas Gastrointestinais em Pacientes Oncológicos Submetidos à Quimioterapia

Casari¹,

Silva²,

Fernandes³

et al. 2021

Rev. Bras. Cancerol.

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Introdução: O estado nutricional do paciente oncológico apresenta grande variação ao longo da doença, além de efeitos adversos relacionados ao trato gastrointestinal serem comuns durante o tratamento quimioterápico. Objetivo: Avaliar o estado nutricional e a presença de sintomas gastrointestinais em pacientes oncológicos submetidos à quimioterapia. Método: Estudo transversal com pacientes em tratamento no setor de Quimioterapia do Hospital Escola da Universidade Federal de Pelotas (UFPel), RS, no período de abril a julho de 2019. Dados sociodemográficos e questões relacionadas à doença foram obtidos por meio de um questionário. Para avaliação do estado nutricional e dos sintomas gastrointestinais, utilizou-se a avaliação subjetiva global produzida pelo paciente. A análise dos dados foi realizada por meio de análise descritiva, e a associação entre variáveis categóricas, verificada pelo teste qui-quadrado de Pearson (p<0,05). Resultados: Foram avaliados 101 pacientes, com média de idade de 58,6 anos e maior prevalência de indivíduos do sexo feminino (58,4%), de cor branca (77,2%), casados (53,0%), pertencentes à classe C (50,4%). Encontrou-se maior prevalência dos cânceres do trato gastrointestinal (34,6%) e mama (27,8%). A maioria dos pacientes foi classificada como bem nutrido (66,3%), enquanto saciedade precoce (56,0%), xerostomia (54,0%), inapetência (42,0%) e náusea (37,0%) foram os sintomas mais citados. Não foi encontrada associação estatística entre o estado nutricional e qualquer um dos sintomas gastrointestinais. Conclusão: O estado nutricional da maioria dos pacientes foi classificado como bem nutrido, mas necessitando de atenção para a ocorrência dos sintomas gastrointestinais.

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Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes

Abstract: This study identified new factors (e.g., poorer functional status, stress) associated with CIN occurrence. CIN negatively impacted patients' QOL. Pre-emptive and ongoing interventions may alleviate CIN occurrence in high-risk patients.

Cited by 15 publications

References 52 publications

Co-occurring Gastrointestinal Symptoms Are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy

Co-occurring Gastrointestinal Symptoms Are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy

Perturbations in Endocytotic and Apoptotic Pathways Are Associated With Chemotherapy-Induced Nausea

Estado Nutricional e Sintomas Gastrointestinais em Pacientes Oncológicos Submetidos à Quimioterapia

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