Chemotherapy-induced nausea and vomiting prophylaxis in pediatric patients at a teaching hospital: assessment of adherence to guidelines

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DOI:

https://doi.org/10.30968/rbfhss.2023.142.0904

Abstract

Aims: Describing the adherence rate of antiemetic prophylaxis in pediatric patients using antineoplastic agents and possible associated factors. Methods: It is a retrospective cross-sectional study, which took place in a teaching hospital at Belo Horizonte. There were included pediatric patients that received chemotherapy at the hospital from January to June, 2022. The demographic, clinical and pharmacotherapeutic data were collected from physicians’ prescriptions and patients’ charts. Descriptive analysis was performed and the results were expressed by absolute and relative frequency for categorical variables and by measures of central tendency and dispersion for numeral variables. Univariate analysis was done in order to assess the association between chemotherapy induced nausea and vomiting and exposure variables. It was calculated through Pearson’s chi-square test. It was considered statistically significant a p-value less than 0,05. Results: It was observed that the prescription practice was closer to recommendations made by guidelines of American Society of Clinical Oncology and Multinational Association of Supportive Care in Cancer | European Society of Medical Oncology with 62% of adherence, meanwhile Pediatric Oncology Group of Ontario had 4,6% of concordance. Underuse of antiemetics was the principal reason for discordance. In particular the lack of dexamethasone prescription. It was identified statistically significance association between nausea and vomiting registers and vincristine and cyclophosphamide use. Conclusions: This study detected high adherence to the American Society of Clinical Oncology and Multinational Association of Supportive Care in Cancer | European Society of Medical Oncology guidelines, even though, the number of observed nausea and vomiting events flag up a potential failure in the antiemetic prophylaxis. The associative analyses between nausea and vomiting registers and vincristine and cyclophosphamide use were statistically significant.

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References

Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi:10.3322/caac.21660

Simino GPR, Reis IA, Acurcio FA, et al. Risk factors associated with antineoplastic chemotherapy-induced nausea and vomiting. Rev Saude Publica. 2020;54(106):1-13. doi:10.11606/s1518-8787.2020054002178

Phillips RS, Gopaul S, Gibson F, et al. Antiemetic medication for prevention and treatment of chemotherapy induced nausea and vomiting in childhood. Cochrane Database of Systematic Reviews. 2010;(9). doi:10.1002/14651858.cd007786.pub2

McKinnon K, Jupp J, Ghosh S, et al. Adherence to pediatric acute chemotherapy-induced nausea and vomiting guidelines in Canadian hospitals. Pediatr Blood Cancer. 2019;66(1):e27488. doi:10.1002/pbc.27488

Patel P, Robinson PD, Orsey A, et al. Chemotherapy-Induced Nausea and Vomiting Prophylaxis: Practice Within the Children’s Oncology Group. Pediatr Blood Cancer. 2016;63(5):887-892. doi:10.1002/pbc.25915

Sherani F, Boston C, Mba N. Latest Update on Prevention of Acute Chemotherapy-Induced Nausea and Vomiting in Pediatric Cancer Patients. Curr Oncol Rep. 2019;21(10):89. doi:10.1007/s11912-019-0840-0

Jordan K, Roila F, Molassiotis A, et al. Antiemetics in children receiving chemotherapy. MASCC/ESMO guideline update 2009. Supportive Care in Cancer. 2011;19(SUPPL. 1)S37-42. doi:10.1007/s00520-010-0994-7

Navari RM. Nausea and Vomiting in Advanced Cancer. Curr Treat Options Oncol. 2020;21(2):14. doi:10.1007/s11864-020-0704-8

Roila F, Aapro M, Ballatori E, et al. Prevention of chemotherapy- and radiotherapy-induced emesis: Results of the 2004 Perugia International Antiemetic Consensus Conference. Annals of Oncology. 2006;17(1):20-28. doi:10.1093/annonc/mdj078

LeBaron S, Zeltzer LK, LeBaron C, et al. Chemotherapy Side Effects in Pediatric Oncology Patients: Drugs, Age, and Sex as Risk Factors. 1988;16(4):263-268. doi: 10.1002/mpo.2950160408

Holdsworth MT, Raisch DW, Frost J. Acute and delayed nausea and emesis control in pediatric oncology patients. Cancer. 2006;106(4):931-940. doi:10.1002/cncr.21631

Albuquerque AS, Okumura LM, Betin-de-Moraes NR, et al. Pediatric related risk factors in acute and delayed chemotherapy-induced nausea and vomiting: multivariate analysis. Brazilian Journal of Oncology. 2022;18:e-20200292. doi:10.5935/2526-8732.20220292

Patel P, Robinson PD, Thackray J, et al. Guideline for the prevention of acute chemotherapy-induced nausea and vomiting in pediatric cancer patients: A focused update. Pediatr Blood Cancer. 2017;64(10):e26542. doi:10.1002/pbc.26542

Paw Cho Sing E, Robinson PD, Flank J, et al. Classification of the acute emetogenicity of chemotherapy in pediatric patients: A clinical practice guideline. Pediatr Blood Cancer. 2019;66(5):e27646. doi:10.1002/pbc.27646

Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO Guideline Update. 2020; J. Clin. Oncol. 38(24):2782-2797. doi: 10.1200/JCO.20.01296

Dupuis LL, Sung L, Molassiotis A, et al. 2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children. Supportive Care in Cancer. 2017;25(1):323-331. doi:10.1007/s00520-016-3384-y

Jordan K, Chan A, Gralla RJ, et al. 2016 Updated MASCC/ESMO consensus recommendations: Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents. Supportive Care in Cancer. 2017;25(1):271-275. doi:10.1007/s00520-016-3332-x

Bun S, Kunisawa S, Sasaki N, et al. Analysis of concordance with antiemetic guidelines in pediatric, adolescent, and young adult patients with cancer using a large-scale administrative database. Cancer Med. 2019;8(14):6243-6249. doi:10.1002/cam4.2486

Phillips RS, Friend AJ, Gibson F, et al. Antiemetic medication for prevention and treatment of chemotherapy-induced nausea and vomiting in childhood. Cochrane Database of Systematic Reviews. 2016;(2). doi:10.1002/14651858.CD007786.pub3

Beauchemin M, Sung L, Hershman DL, et al. Guideline concordant care for prevention of acute chemotherapy-induced nausea and vomiting in children, adolescents, and young adults. Supportive Care in Cancer. 2020;28(10):4761-4769. doi:10.1007/s00520-020-05310-6

Pulido JZ, Aleixo SB. Antieméticos em oncologia. Rev. Bras. Oncologia Clínica. 2004;1(3):35-40.

Consenso Brasileiro de Náuseas e Vômitos. Rev. Bras. Cuidados Paliativos. 2011;3(3 – suplemento 2).

Published

2023-06-27

How to Cite

1.
ALVES SR, COSTA IH, LIMA CS, GROIA-VELOSO RC, OLIVEIRA GC, CHEMELLO C. Chemotherapy-induced nausea and vomiting prophylaxis in pediatric patients at a teaching hospital: assessment of adherence to guidelines. Rev Bras Farm Hosp Serv Saude [Internet]. 2023Jun.27 [cited 2024Dec.26];14(2):904. Available from: https://rbfhss.org.br/sbrafh/article/view/904

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ORIGINAL ARTICLES

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