Abstract
At the University of Maryland Marlene and Stewart Greenebaum Cancer Center, we noticed that patients did not routinely receive a guideline recommended antiemetic regimen for the prevention of chemotherapy induced emesis. To achieve better compliance, treatment guidelines were incorporated into chemotherapy preprinted orders. The purpose of this study is to evaluate outcomes in the delayed period following highly emetogenic chemotherapy in patients receiving a guideline recommended antiemetic regimen. Outcomes were compared to a historical cohort of patients who did not receive a guideline recommended regimen.
This prospective, observational, quality-assessment study enrolled patients receiving highly emetogenic chemotherapy who received a standard delayed antiemetic regimen of dexamethasone for 5 days plus dolasetron for 3 days. Patients documented the number of emesis episodes, breakthrough nausea with medication use, and adverse effects. Quality of life was measured using the Modified Functional Living Index – Emesis. Originally, 40 to 60 patients were planned to be studied. This study was stopped early, because national consensus guidelines for preventing chemotherapy induced nausea and vomiting were recently updated and no longer recommended this regimen.
Overall, the incidence of vomiting was statistically similar (P= 0.4) in the prospective study cohort (77.8%) vs the historical cohort (65.2%). Also, breakthrough antiemetic use was similar in both groups. Complete response was similar between the two groups (27.8% current, 30.4% historic).
Outcomes were similar in the current study vs the historical cohort. The institution's guidelines were modified and further studies will assess the efficacy of newer antiemetic regimens using these data as historical control.
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