Late Chemotherapy‑Induced Nausea and Vomiting after Cisplatin Treatment for Patients with Esophageal or Gastric Cancer

Background: Chemotherapy‑induced nausea and vomiting (CINV usually resolves within 5 days of chemo‑ therapy initiation. However some patients have CINV at 6 days or later after chemotherapy initiation (late CINV. We evaluated the incidence of late CINV and the effectiveness of aprepitant plus palonosetron in pre‑ venting late CINV. Methods: We retrospectively reviewed the records of 102 patients with esophageal or gastric cancer to de‑ termine CINV incidence on days 1 through 21 after initiation of cisplatin treatment. Sixty‑six patients re‑ ceived a first‑generation 5‑hydroxytryptamine (serotonin type 3 receptor antagonist and 36 received aprepitant plus palonosetron. In addition we compared the effectiveness of antiemetic regimens before and after administering aprepitant and palonosetron. CINV was defined as presence of grade 1 or higher vomit‑ ing or grade 2o r higher nausea. Results: In the aprepitant plus palonosetron group the highest incidence of CINV (42％ was seen at 7 days after initiation of cisplatin treatment. CINV incidence started to gradually decrease at 8 days after cis‑ platin initiation. There was no significant intergroup difference in the incidence of late CINV. Conclusions: Late CINV may develop in patients receiving cisplatin for treatment of esophageal or gastric cancer. Our findings suggest that the widely used prophylaxis for delayed CINV resulting from highly eme‑ togenic chemotherapy is not satisfactorily effective against late CINV. J Med Soc Toho 61 (5: 218―223 2014