Pediatric related risk factors in acute and delayed chemotherapyinduced nausea and vomiting: multivariate analysis

ABSTRACT

Objectives: This study aimed to characterize the clinical profile and the factors that predispose chemotherapy-induced nausea and vomiting (CINV) in the acute and delayed phases.

Methods: A retrospective cohort study was conducted in a Brazilian hospital with pediatric patients under 18 years old receiving moderately or highly emetogenic chemotherapy. Thus, a descriptive analysis was performed to characterize this population, followed by univariate and multivariate analysis to evaluate the risk factors for CINV. In both phases, considering significant the variables with p-values <0.05.

Results: The median age was 6 and 71% of the patients included used highly emetogenic protocols. Furthermore, 41% and 76% did not have vomit in the acute and delayed phase, respectively. Through logistic regression, it is noted that patients with bone tumors and sarcomas have higher CINV in the acute phase (OR 10.0, 95%IC 1.1-88.9, p=0.039), while patients who do not have complete control in the acute phase are more likely to have CINV in the delayed phase (OR 11.8, 95%IC 1.1-130.5, p=0.044).

Conclusion: These results suggest that bone tumors and sarcomas are associated with an increase in CINV in the acute phase. In addition, control in the acute phase is associated with a complete response in the delayed phase.

RESUMO

Objetivos: Este estudo teve como objetivo caracterizar o perfil clínico e os fatores que predispõem a náuseas e vômitos induzidos por quimioterapia (NVIQ) nas fases aguda e tardia.

Métodos: Foi realizado um estudo de coorte retrospectivo em um hospital brasileiro com pacientes pediátricos menores de 18 anos recebendo quimioterapia moderada ou altamente emetogênica. Assim, foi realizada uma análise descritiva para caracterizar essa população, seguida de análise univariada e multivariada para avaliar os fatores de risco para NVIQ. Em ambas as fases, considerando significativas as variáveis com valores de p<0,05.

Resultados: A mediana de idade foi de 6 anos e 71% dos pacientes incluídos usavam protocolos altamente emetogênicos. Além disso, 41% e 76% não apresentaram vômito na fase aguda e tardia, respectivamente. Por meio de regressão logística, nota-se que pacientes com tumores ósseos e sarcomas apresentam maior NVIQ na fase aguda (OR 10,0, IC95% 1,1-88,9, p=0,039), enquanto os pacientes que não possuem controle completo na fase aguda são maior probabilidade de ter CINV na fase tardia (OR 11,8, IC95% 1,1-130,5, p=0,044).

Conclusão: Esses resultados sugerem que tumores ósseos e sarcomas estão associados a um aumento de NVIQ na fase aguda. Além disso, o controle na fase aguda está associado a uma resposta completa na fase tardia.

Keywords:

Vomiting - Chemotherapy - Pediatric - Oncology - Antiemetics

Descritores:

Vômitos - Quimioterapia - Pediátrico - Oncologia - Antieméticos

Publication History

Received: 11 August 2021

Accepted: 23 October 2021

Article published online:
09 March 2022

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