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A novel prospective descriptive analysis of nausea and vomiting among patients receiving gastrointestinal radiation therapy

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Abstract

Purpose

Nausea and vomiting are common side effects from radiotherapy that can interfere with gastrointestinal (GI) cancer patients’ quality of life (QOL). This study described the subjective experience of patients with radiation-induced nausea and vomiting (RINV) and its relation to QOL.

Methods

Forty-eight patients treated with abdominal radiotherapy alone or with concomitant chemoradiotherapy were followed in a prospective study. All episodes of nausea, vomiting, and antiemetic use were recorded daily for the treatment period and the week following completion of therapy. QOL was assessed weekly using the Functional Living Index—Emesis QOL Tool (FLIE) and the EORTC QLQ-C30 core questionnaire (C30).

Results

In total, 351 episodes of nausea severity, duration, onset time, and 154 outcomes of vomiting onset times and contents were documented. The median nausea severity experienced per episode was 5 (on a scale from 1 to 10), and the most common durations of nausea were 30 min or less and constant nausea all day and night. The most common location of nausea was the abdomen. Longer nausea duration, great nausea severities, and the location of nausea experienced had significant adverse relationships to multiple QOL items on both the FLIE and the C30. In addition, the onset timing and number of vomiting episodes were related to the majority of all FLIE and QOL scores.

Conclusion

Patient’s subjective experiences of RINV directly correlated to the worsening of QOL outcomes. The identification and amelioration of these RINV experiences could improve QOL.

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Acknowledgments

We thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Joey and Mary Furfari Cancer Research Fund, Pulenzas Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Michael Poon, Jonathan Hwang, Carlo DeAngelis, Liying Zhang, Hans Chung, Jordan Stinson, Shun Wong, Natalie Pulenzas & Edward Chow

  2. Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada

    Kristopher Dennis

  3. Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Kristopher Dennis

  4. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada

    Edward Chow

Authors
  1. Michael Poon
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  2. Jonathan Hwang
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  3. Kristopher Dennis
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  4. Carlo DeAngelis
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  5. Liying Zhang
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  6. Hans Chung
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  7. Jordan Stinson
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  8. Shun Wong
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  9. Natalie Pulenzas
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  10. Edward Chow
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Corresponding author

Correspondence to Edward Chow.

Appendix 1. FLIE

Appendix 1. FLIE

1. How much nausea have you had in the past 3 days?

      

1

2

3

4

5

6

7

None

     

A great deal

2. Has nausea affected your ability to maintain usual recreation or leisure activities in the past 3 days?

      

1

2

3

4

5

6

7

None

     

A great deal

3. Has nausea affected your ability to make a meal or do minor household repairs during the past 3 days?

      

1

2

3

4

5

6

7

A great deal

     

Not at all

4. How much has nausea affected your ability to enjoy a meal in the past 3 days?

      

1

2

3

4

5

6

7

Not at all

     

A great deal

5. How much has nausea affected your ability to enjoy liquid refreshment in the past 3 days?

      

1

2

3

4

5

6

7

Not at all

     

A great deal

6. How much has nausea affected your willingness to see and spend time with family and friends, in the past 3 days?

      

1

2

3

4

5

6

7

A great deal

     

Not at all

7. Has nausea affected your daily functioning in the past 3 days?

      

1

2

3

4

5

6

7

Not at all

     

A great deal

8. Rate the degree to which your nausea has imposed a hardship on you (personally) in the past 3 days.

      

1

2

3

4

5

6

7

Not at all

     

A great deal

9. Rate the degree to which your nausea has imposed a hardship on those closest to you in the past 3 days.

      

1

2

3

4

5

6

7

Not at all

     

A great deal

10. How much vomiting have you had in the past 3 days?

      

1

2

3

4

5

6

7

None

     

A great deal

11. Has vomiting affected your ability to maintain usual recreation or leisure activities in the past 3 days?

      

1

2

3

4

5

6

7

A great deal

     

Not at all

12. Has vomiting affected your ability to complete your usual household tasks during the past 3 days?

      

1

2

3

4

5

6

7

Not at all

     

A great deal

13. How much has vomiting affected your ability to enjoy a meal in the past 3 days?

      

1

2

3

4

5

6

7

Not at all

     

A great deal

14. How much has vomiting affected your ability to enjoy liquid refreshment in the past 3 days?

      

1

2

3

4

5

6

7

Not at all

     

A great deal

15. How much has vomiting affected your willingness to see and spend time with friends, in the past 3 days?

      

1

2

3

4

5

6

7

A great deal

     

Not at all

16. Has vomiting affected your daily functioning in the past 3 days?

      

1

2

3

4

5

6

7

Not at all

     

A great deal

17. Rate the degree to which your vomiting has imposed a hardship on you (personally) in the past 3 days.

      

1

2

3

4

5

6

7

Not at all

     

A great deal

18. Rate the degree to which your vomiting has imposed a hardship on those closest to you in the past 3 days.

      

1

2

3

4

5

6

7

A great deal

     

Not at all

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Poon, M., Hwang, J., Dennis, K. et al. A novel prospective descriptive analysis of nausea and vomiting among patients receiving gastrointestinal radiation therapy. Support Care Cancer 24, 1545–1561 (2016). https://doi.org/10.1007/s00520-015-2942-z

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  • DOI: https://doi.org/10.1007/s00520-015-2942-z

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