In:
Journal of Pediatric Oncology Nursing, SAGE Publications, Vol. 31, No. 5 ( 2014-09), p. 277-283
Abstract:
Purpose: Chemotherapy-induced nausea and vomiting are common and distressing side effects in patients with brain tumors and may be associated with radiation and the administration of highly emetogenic chemotherapy (HEC). Pediatric antiemetic guidelines recommend administration of a 5-hydroxytryptamine-3 (5HT 3 ) receptor antagonists and the addition of aprepitant, a neurokinin 1 (NK 1 ) antagonist with corticosteroids for the treatment of HEC. However, challenges persist in treating chemotherapy-induced nausea and vomiting in patients with brain tumors as corticosteroids are contraindicated due to potential impairment of the blood–brain barrier permeability. The objective was to determine whether a 5HT 3 receptor antagonist and the addition of aprepitant, an NK 1 antagonist without a corticosteroid, were effective in reducing HEC vomiting in pediatric brain tumor patients. Method: A retrospective review found that 18 patients with a history of high-grade vomiting during radiation were prescribed a 5HT 3 receptor antagonist and aprepitant without a corticosteroid during their first course of HEC. To determine the efficacy of aprepitant without a corticosteroid, each recipient was matched with 2 controls who did not receiv aprepitant. Results: During HEC, controls without aprepitant were more likely to have Grade 2 or higher vomiting than the aprepitant recipients ( P = .03; odds ratio = 4.15; 95% confidence interval = 1.59-10.82), after controlling for radiation-associated vomiting toxicity. Discussion: Significantly less vomiting was identified in children receiving HEC and prescribed a 5HT 3 receptor antagonist and aprepitant. Findings suggest that the addition of an NK 1 antagonist may be beneficial to emetic control in this highly vulnerable population.
Type of Medium:
Online Resource
ISSN:
1043-4542
,
1532-8457
DOI:
10.1177/1043454214531090
Language:
English
Publisher:
SAGE Publications
Publication Date:
2014
detail.hit.zdb_id:
3122666-8
detail.hit.zdb_id:
2052954-5
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