Evaluation of the Efficacy of Aprepitant on the Prevention of Chemotherapy-Induced Nausea and Vomiting and Quality of Life with Functional Living Index Emesis
Abstract
Objective: Functional Living Index Emesis (FLIE) is developed to evaluate the relationship between emesis and it's effects on patient's daily life and is far more relevant to detect the effectiveness of antiemetic treatment compared with self-diary reports. In this study, the efficacy of oral neurokinin-1 antagonist aprepitant on the prevention of chemotherapy-induced nausea and vomiting and quality of life is evaluated with FLIE. Study Design: Cross sectional study. Material and Methods: Sixty patients with Non-Small Cell Lung Cancer (NSCLC) receiving a chemotherapy regimen consisting of Cisplatin and Docetaxel were evaluated. The patients were prospectively randomized to two groups before the first cycle of chemotherapy. Patients in Group A (31 patients) received 3 daily doses of aprepitant along with oral ondansetron and dexamethasone. The patients in group B (29 patients) received only ondansetron and dexamathasone. The efficacy of both regimens was evaluated by a modified Turkish version of FLIE scale consisting of 18 questions. Results: The number of patients with complete response was 31 in the whole group. Of these 18 patients (58%) were in Group A (Aprepitant) and 13 patients in group B (42%). Median FLIE score in group A was 24.97 (±12.45) while it was 38.1 (±26.987) in group B and the difference was statistically significant (p=0.022). Total score >20 was seen in only 5 of 31 patients in aprepitant group (16%) showing the significant efficiency of aprepitant on quality of life, while in group B, 13 of 29 patients (44%) had total scores >20 (p=0.02). Conclusion: Regarding these findings, it is certain to state that aprepitant in combination with other drugs optimizes protection against both nausea and vomiting compared to the prior standard of care, and must be recommended as first-line therapy for patients who are treated with moderately or highly emetogenic chemotherapy. Turkish Başlık: Yüksek emetojenik riskli kemoterapi uygulanan Akciğer kanserli hastalarda Oral Nörokinin antagonisti olan Aprepitant'ın hayat kalitesi üzerine etkinliğinin Fonksiyonel Yaşam Bulantı İndeksi (FLIE) ile değerlendirilmesi Anahtar Kelimeler: Aprepitant, kusma, hayat kalitesi, FLIE, kemoterapi Amaç: Fonksiyonel Yaşam Bulantı İndeksi (FLIE), kusma ile yaşam kalitesi arasındaki ilişkiyi değerlendirmek üzere geliştirilmiştir ve kişisel günlük bildirimlerden çok daha duyarlı bir metottur. Çalışmamızda, oral nörokinin antagonisti Aprepitant'ın, bulantı-kusma ve hayat kalitesi üzerine etkinliği FLIE ile değerlendirilmiştir. Gereç ve Yöntemler: Sisplatin ve Dosetaksel kombine kemoterapisi uygulanan 60 Akciğer Kanseri tanılı hasta çalışmaya dahil edildi. İlk kür kemoterapi öncesinde hastalar prospektif olarak iki gruba randomize edildi. Grup A daki hastalar (31 hasta) 3 gün üst üste oral aprepitant ile birlikte ondansetron ve deksametazon aldı. Grup B deki hastalara (29 hasta) ise sadece ondansetron ve deksametazon verildi. Her iki rejimin etkinliği, Tükçe'ye çevrilen ve 18 sorudan oluşan modifiye FLIE skalası ile değerlendirildi. Bulgular: Tüm grupta tam yanıt elde edilen toplam hasta sayısı 31 oldu. Bunların 18 tanesi (%58) Grup A, 13 tanesi ise (%42) Grup B'e dahil olan hastalardı. Ortanca FLIE skoru, grup A hastalarda 24.97 (± 12.45) olurken, grup B de ise 38.1 (± 26.987) olarak belirlendi ve aralarındaki fark istatistiksel olarak anlamlı bulundu (p=0.022). Total skor > 20 değerleri Grup A'da sadece 5 hastada (%16) tesbit edilirken, grup B hastalarda bu sayı 13 hasta (%44) olarak belirlendi (p=0.02) Sonuç: Bu bulgular da göstermektedir ki; aprepitant, bulantı ve kusmayı önlemede, diğer ilaçlarla kombine olarak kullanıldığında, daha önceki standart tedavilere kıyasla daha fazla etkinlik göstermektedir ve orta veya yüksek emetojenik riskli kemoterapi alan hastalarda ilk basamak tedavi olarak önerilmelidir.
Keywords
References
- Richardson JL, Marks G, Levine A. The influence of symptoms of disease and side effects of treatment on compliance with cancer therapy. J Clin Oncol 1988;5:1746-52. Lazslo J. Emesis as limiting toxicity in cancer chemotherapy. In Lazslo J, ed. Antiemetics and cancer chemotherapy. Baltimore, Maryland:Williams & Wilkins 1983:1-5. Borison HL, Wang S. Physiology and pharmacology of vomiting. Pharmacol Rev 1953;5:193-230.
- Siegel LJ, Longo DL. The control of chemotherapy induced emesis. Ann Intern Med 1981;95:352-9.
Evaluation of the Efficacy of Aprepitant on the Prevention of Chemotherapy-Induced Nausea and Vomiting and Quality of Life with Functional Living Index Emesis
Abstract
References
- Richardson JL, Marks G, Levine A. The influence of symptoms of disease and side effects of treatment on compliance with cancer therapy. J Clin Oncol 1988;5:1746-52. Lazslo J. Emesis as limiting toxicity in cancer chemotherapy. In Lazslo J, ed. Antiemetics and cancer chemotherapy. Baltimore, Maryland:Williams & Wilkins 1983:1-5. Borison HL, Wang S. Physiology and pharmacology of vomiting. Pharmacol Rev 1953;5:193-230.
- Siegel LJ, Longo DL. The control of chemotherapy induced emesis. Ann Intern Med 1981;95:352-9.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | January 1, 2013 |
| Published in Issue | Year 2013 |