Estudio comparativo de eficacia y seguridad de dos protocolos antieméticos en quimioterapia ginecológica

Objectives: To evaluate the efficacy and safety of an update to an anti-emetic protocol in chemotherapy for gynecological tumours. Method: Prospective observational study performed over 12 months in a general hospital with 400 beds. We evaluated the efficacy of the old anti-emetic protocol, a new protocol was implemented, and its efficacy was determined. We included patients with gynaecological tumours that sought treatment at the Day Hospital. After each chemotherapy cycle, patients filled out a survey that registered the number and severity of episodes of nausea/vomiting and other adverse effects. The efficacy of treatment was measured as complete response (no nausea or vomit) in the acute phase (first 24 h after chemotherapy) and late phase (2-5 days after chemotherapy). We also evaluated whether age, the type of protocol, and the emetogenous power of the different treatment schemes could influence patient response. Results: We analysed 102 chemotherapy cycles under the old protocol (52 patients) and 293 cycles under the new protocol (98 patients). We observed significant differences in complete response rates in the late phase between old and new protocols (36.27% vs 67.38%, P<.0001). The probability of obtaining a complete response using the new protocol was twice as high as with the old protocol in acute emesis (OR = 1.85, 95% CI: 1.05-3.24, P=.03) and four times higher in late emesis (OR = 4.27, 95% CI: 2.59-7.02, P<.0001). Conclusions: A greater percentage of complete responses to late emesis was obtained using the new protocol. Age and the low emetogenous power of the treatment schemes were predictive factors for complete response in acute emesis.