The Role of Clinical Guidelines for the Management of Chemotherapy-Induced Nausea and Vomiting in Children with Cancer

Hamid  Farhangi; Ali  Ghasemi; Mojgan  Bahari; Zohreh Alirezaei; Akram Rabbani Javadi; Zahra  Badiee; Fatemeh  Nanvabashi

doi:10.18502/ijpho.v12i1.8357

Hamid Farhangi Department of Pediatrics Hematology & Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. - - Dr. Sheikh Hospital, Taheri Str. Mashhad, Iran
Ali Ghasemi Department of Pediatrics Hematology & Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. - - Dr. Sheikh Hospital, Taheri Str. Mashhad, Iran
Mojgan Bahari Department of Pediatrics Hematology & Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. - - Dr. Sheikh Hospital, Taheri Str. Mashhad, Iran
Zohreh Alirezaei Department of Pediatrics Hematology & Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. - - Dr. Sheikh Hospital, Taheri Str. Mashhad, Iran
Akram Rabbani Javadi Department of Pediatrics Hematology & Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. - - Dr. Sheikh Hospital, Taheri Str. Mashhad, Iran
Zahra Badiee Department of Pediatrics Hematology & Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. - - Dr. Sheikh Hospital, Taheri Str. Mashhad, Iran
Fatemeh Nanvabashi Department of Pediatrics Hematology & Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. - - Dr. Sheikh Hospital, Taheri Str. Mashhad, Iran

DOI: https://doi.org/10.18502/ijpho.v12i1.8357

Keywords: Drug therapy, Nausea, Neoplasms, Practice guideline, Vomiting

Abstract

Background: Nausea and vomiting are among the most important side-effects associated with chemotherapy in children with cancer, affecting the quality of their lives. Clinical guidelines for selecting antiemetics are effective in reducing acute chemotherapy-induced nausea and vomiting (CINV).

Materials and Methods: The present quasi-experimental study compared the effectiveness of the Pediatric Oncology Group of Ontario (POGO) CINV guideline with that of conventional arbitrary therapies for CINV in 82 children aged 6 months to 16 years old. Out of 177 cycles of chemotherapy, in 101 cycles patients were treated according to POGO-CINV Guideline; in the other 76 cycles, patients were treated with arbitrary types and doses of antiemetics. Then, vomiting in the first 24 hours after chemotherapy in both groups was measured and compared.

Results: In this study, 82 patients hospitalized in the Hematology Department of Dr. Sheikh Children’s Hospital were enrolled, of whom 48 patients (58.7%) were boys and 34 (41.3%) were girls. The mean age of patients was 6.24±4.47 years (6 months to 16 years). The results of the current study showed that using a protocol for the prevention of vomiting based on the patient’s age and the type of chemotherapy is superior to conventional management of CINV. Findings showed that the frequency of nausea and vomiting in the protocol group was significantly reduced in comparison with the control group (p˂0.005). Moreover, a reduction in the frequency of nausea and vomiting was quite significant in the sub-categories of the protocol group who had received high-risk or moderate-risk emetogenic drugs (p˂0.005).

Conclusion: The results of the current study showed that using the POGO guideline, which takes into account the patient’s age and the type of chemotherapy, is more effective than arbitrary management of CINV, particularly in children.