Vomiting associated with whole body irradiation

Area of Science:

• Oncology
• Radiation Oncology
• Clinical Medicine

Background:

• Bone marrow transplantation (BMT) frequently involves total body irradiation (TBI).
• Nausea and vomiting are common side effects of TBI.
• Understanding TBI-induced vomiting patterns is crucial for patient care.

Purpose of the Study:

• To investigate the patterns and influencing factors of vomiting in patients undergoing TBI before BMT.
• To identify thresholds for TBI dose triggering vomiting.
• To explore methods for reducing the incidence of TBI-induced vomiting.

Main Methods:

• Observational study of 305 patients undergoing TBI prior to BMT.
• Dose monitoring and recording of vomiting episodes.
• Analysis of patient factors (age, anxiety) and interventions (sedation, movement limitation).

Main Results:

• Vomiting typically begins after 2-3 Gy TBI, persisting up to 12 hours, with recurrence at 2-5 days.
• Fractionated radiation (<2 Gy fractions) showed infrequent vomiting, unrelated to cumulative dose beyond a threshold.
• Reduced incidence observed with patient movement limitation and adequate sedation; increased with anxiety. Higher incidence in patients aged 10-40.

Conclusions:

• Vomiting following TBI is dose-dependent up to a threshold and influenced by patient factors and interventions.
• Sedation and minimizing patient movement are effective in reducing TBI-induced vomiting.
• Complete prevention of vomiting is achievable in 50% of patients, suggesting potential for optimized antiemetic strategies.