Medical pretreatment relieves chemotherapy-induced vomiting in lung cancer patients

Abstract

Objective: To investigate whether medical interventions on the gastrointestinal symptoms before chemotherapy-in- duced vomiting can relieve vomiting, and to identify the optimal measures to prevent chemotherapy-induced vomiting. Methods: Data from 229 cases undergoing chemotherapy were enrolled into this clinical study. Patients were randomly assigned into two groups at a ra- tio of 1∶1, and recognized 5-HT3 receptor antagonists were administered to the patients during chemotherapy. In the intervention group, the protocols were also conducted during chemotherapy, which were designed as the combined agents metoclopramide, diphenhydr- amine, mziren capsule, and medroxyprogesterone in group 1 and only metoclopramide in group 2. Empirical medicines were given to the control group only when grade 2 (CTCEA v4.0) or stronger gastrointestinal symptoms occurred. The antiemetic efficacy was de- fined to have four levels, '0' means no vomiting, '1'means 1 to 2 episodes occurred in 24 hours, '2' means 3 to 5 episodes in 24 hours, and '3' means 6 or more episodes in 24 hours. Levels 0 and 1 are regarded as response to the treatment, and levels 2 and 3 as failure. The vomit prevention effects in the two groups were compared using the Multi-sample Rank Sum Test, and the effects in the subgroups were compared in a pairwise manner. Results: A total of 305 chemotherapeutic cycles were carried out, including 150 cycles in the in- tervention group: protocol 1 was performed using 76 cycles, and protocol 2 was performed using 74 cycles. There were 155 cycles in the control group. The multi-sample rank sum test (Kruskal-Wallis test) shows that the mean ranks of the antiemetic effects are 93.39, 150.13, and 183.60 in subgroups 1 and 2, and the control group, respectively. The difference between groups 1 and 2 was 56.74 (P< 0.001). The response rate of group 1 was significantly superior to that of group 2 (P=0.015). The Chi-square test shows that the differ- ences of KPS before and after the chemotherapy are significant (P<0.001). Conclusion: Medical intervention on the premonitory symp- toms can significantly relieve chemotherapy-induced vomiting, improve the quality of life of the patient, and ensure a smooth progress in the chemotherapy. The vomiting relieving effect of the metoclopramide, diphenhydramine, mziren capsule, and medroxyprogesterone treatment is better than the single-agent protocol and should be recommended as the regimen of preventing chemotherapy-induced vom-