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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

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Delayed Chemotherapy-Induced Nausea - A Nurse-Led International Observational Study in Routine Oncology Practice

Ramona Engst¹, Agnes Glaus², Ulrike Moessner³

¹School of Health, OST Eastern Switzerland University of Applied Sciences, St.Gallen, Switzerland.

SAGE Open Nursing

|December 8, 2025

Summary

Delayed chemotherapy-induced nausea (dCIN) affects nearly 19% of patients receiving low emetogenic chemotherapy (LEC). This highlights the need for better symptom management strategies beyond current risk classifications for cancer patients.

Keywords:

Delayed chemotherapy-induced nausea oncology nursing prevalence supportive care survey

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Area of Science:

Oncology
Clinical Pharmacology
Patient Quality of Life

Background:

Chemotherapy-induced nausea and vomiting (CINV) significantly impacts patient quality of life and treatment adherence.
Delayed CINV (dCIN) is commonly associated with moderate/high emetogenic chemotherapy but can occur with low (LEC) and minimal (MinEC) regimens.
Real-world data on dCIN occurrence, particularly with LEC and MinEC, is crucial for optimizing supportive care.

Purpose of the Study:

To assess the incidence and characteristics of delayed chemotherapy-induced nausea (dCIN) in patients undergoing systemic antitumour therapy.
To specifically evaluate dCIN occurrence in patients receiving low (LEC) and minimally emetogenic chemotherapy (MinEC).
To identify risk factors associated with dCIN in a real-world clinical setting.

Main Methods:

Prospective, multicentre, international, cross-sectional study.
Adult oncology outpatients receiving systemic antitumour therapy were enrolled.
Delayed CINV intensity was self-rated daily using a 0-100 visual analogue scale (VAS) for five consecutive days.

Main Results:

Delayed chemotherapy-induced nausea (dCIN) occurred in 18.5% of patients receiving low emetogenic chemotherapy (LEC) and 3% receiving minimally emetogenic chemotherapy (MinEC).
Vomiting was infrequent (1.7%).
Independent risk factors for dCIN included younger age and gastrointestinal tumours; emetogenicity, fear, and prior vomiting were not significant predictors in the final model.

Conclusions:

A substantial proportion of patients receiving low emetogenic chemotherapy (LEC) experience delayed chemotherapy-induced nausea (dCIN) in clinical practice.
Current emetogenic risk classifications may not fully capture the risk of dCIN.
Improved symptom management and tailored interventions are necessary for patients experiencing dCIN, irrespective of chemotherapy emetogenicity.