Clinical Significance of Preventing Chemotherapy-Induced Nausea and Vomiting (CINV) in Outpatient'S Chemotherapy Center

ABSTRACT Background To prevent chemotherapy-induced nausea and vomiting (CINV), it is important to use effective antiemetic drugs according to the risk of emetogenicity. 5-HT3 inhibitors and antagonist of NK1 receptor, including palonosetron and aprepitant, which are new approved drugs with long acting function, are available in cancer chemotherapy. Aim and methods To evaluate the usage of antiemetic drugs in outpatient's chemotherapy center of Kumamoto University Hospital, frequency and severity of CINV were analyzed according to the risk of emetic regimen (high, moderate and low) in two periods of 6 months around approval of palonosetron and aprepitant [from April to September 2009 (before approval of drugs) (n = 1439) and from April to September 2011 (after approval of drugs)(n = 1852)]. Results In high emetic risk regimens, half of all patients (38/76 cases) were used aprepitant and the percentage of the administration of palonosetron was 30% (23/76 cases). In the moderate emetic risk group, the usage of aprepitant and palonosetron was 24% (114/484 cases) and 5% (26/484 cases), respectively. The incidence of CINV was higher in the moderate-risk group than the high-risk group. The episode of CINV was significantly reduced in all of the risk group of patients in 2011 compared with them in 2009. Conclusion This study indicated that the incidence of CINV in high emetic risk regimens was reduced by the administration of aprepitant and palonosetron. The aggressive use of antiemetic drugs would be better to improve the quality of life in outpatient's chemotherapy, even if moderate risk of emetic regimens.