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Delayed nausea and vomiting in children receiving antineoplastics
L L Dupuis1, R Lau, M L Greenberg
1Department of Pharmacy, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. lee.dupuis@sickkids.on.ca
Medical and Pediatric Oncology
|August 10, 2001
Summary
Delayed nausea and vomiting from antineoplastic agents are less common in children than adults. Routine antiemetic use during the delayed phase may not be necessary for all pediatric patients.
Area of Science:
- Pediatric Oncology
- Clinical Pharmacology
- Patient Symptom Management
Background:
- Delayed nausea and vomiting (N&V) following antineoplastic therapy in children are not well-characterized.
- Understanding the prevalence and management of delayed N&V is crucial for improving pediatric cancer care.
Purpose of the Study:
- To describe the incidence of delayed nausea and vomiting in children receiving antineoplastic agents.
- To document the antiemetic drug therapies used for prevention or management of delayed N&V in this population.
Main Methods:
- Prospective study of children receiving antineoplastic agents.
- Daily recording of emetic episodes and self-assessed nausea for children (>3 years).
- Assessment of daily diet and antiemetic use during acute and delayed phases.
Main Results:
- 79% of 174 antineoplastic cycles were not associated with delayed vomiting.
- Delayed vomiting was more frequent with cisplatin, carboplatin, cyclophosphamide, multi-day therapy, or acute vomiting.
- Moderate to severe nausea occurred on 58% of study days; 93% of days without antiemetics were vomit-free.
Conclusions:
- Delayed nausea and vomiting appear less prevalent in pediatric patients compared to adults.
- Routine prophylactic antiemetic administration during the delayed phase may not be universally indicated.