Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study

Abstract Objective The aim of the study was to describe the control of acute chemotherapy-induced nausea and vomiting (CINV) in children with solid tumors receiving highly emetogenic chemotherapy (HEC) at our center. Additionally, the study aimed to explore the risk factors for chemotherapy-induced...

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Main Authors: Miaomiao Shao, Ying Li, Jing Qin, Yuchen Zhou, Yixin Sun, Peiyi Yang, Xisi Wang, Cheng Huang, Yan Su, Wen Zhao
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05451-9
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author Miaomiao Shao
Ying Li
Jing Qin
Yuchen Zhou
Yixin Sun
Peiyi Yang
Xisi Wang
Cheng Huang
Yan Su
Wen Zhao
author_facet Miaomiao Shao
Ying Li
Jing Qin
Yuchen Zhou
Yixin Sun
Peiyi Yang
Xisi Wang
Cheng Huang
Yan Su
Wen Zhao
author_sort Miaomiao Shao
collection DOAJ
description Abstract Objective The aim of the study was to describe the control of acute chemotherapy-induced nausea and vomiting (CINV) in children with solid tumors receiving highly emetogenic chemotherapy (HEC) at our center. Additionally, the study aimed to explore the risk factors for chemotherapy-induced vomiting (CIV) with the ultimate goal of enhancing CINV management for children. Methods Children aged 1–18 years with solid tumors treated with HEC were enrolled. A structured diary was used to record CINV data, and the pediatric nausea assessment tool (PeNAT) was employed to assess the degree of nausea. The primary outcome was achieving complete CIV control in the acute phase for all children, and secondary outcomes included the control of acute phase CINV, CIV, and chemotherapy-induced nausea (CIN) in children aged ≥ 4 years. Data on children were prospectively collected, and univariate and multivariate logistic regression was used to explore risk factors for complete CIV control. Results A total of 181 children were included, with 52.5% (95/181) experiencing acute phase complete CIV control. Eighty-six children aged ≥ 4 years could be evaluated for acute phase CINV control, and complete CINV control was achieved in 27.9% (24/86), with CIV, CIN complete control rates were 41.9% (36/86) and 34.9% (30/86), respectively. The results of multivariate logistic regression showed age (< 2 years vs. >6 years: OR = 0.186, 95% CI 0.062 ~ 0.56; 2 ~ 6 years vs. >6 years: OR = 0.322, 95% CI 0.145 ~ 0.715), female (OR = 2.034, 95% CI 1.035 ~ 3.994), duration of chemotherapy block (OR = 1.611, 95%CI 1.039 ~ 2.499), and antiemetic regimen (5-hydroxytryptamine-3 receptor antagonists (5HT3RA) vs. 5HT3RA + dexamethasone: OR = 0.395, 95% CI 0.171 ~ 0.914) were statistically significant in complete CIV control (P < 0.05). Conclusions Children with solid tumors treated with HEC at our center experienced suboptimal control of CINV. Older age, female, and a longer duration of the chemotherapy block were identified as risk factors for complete CIV control. Receipt of 5HT3RA plus dexamethasone had a higher likelihood of acute phase complete CIV control versus 5HT3RA. In the future, individualized management of nausea and vomiting, based on existing CINV guidelines and the unique characteristics of children, will be necessary to reduce the incidence of CINV and improve the quality of life for these children.
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spelling doaj-art-c8b1ab5917464bfdab896158d0d60f352025-02-02T12:42:53ZengBMCBMC Pediatrics1471-24312025-01-012511810.1186/s12887-025-05451-9Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational studyMiaomiao Shao0Ying Li1Jing Qin2Yuchen Zhou3Yixin Sun4Peiyi Yang5Xisi Wang6Cheng Huang7Yan Su8Wen Zhao9Department of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthMedical Oncology Department, Pediatric Oncology Center, National Key Clinical Discipline of Pediatric Oncology, Laboratory for Clinical Medicine, Capital Medical University, Key Laboratory of Maior Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthMedical Oncology Department, Pediatric Oncology Center, National Key Clinical Discipline of Pediatric Oncology, Laboratory for Clinical Medicine, Capital Medical University, Key Laboratory of Maior Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthMedical Oncology Department, Pediatric Oncology Center, National Key Clinical Discipline of Pediatric Oncology, Laboratory for Clinical Medicine, Capital Medical University, Key Laboratory of Maior Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthMedical Oncology Department, Pediatric Oncology Center, National Key Clinical Discipline of Pediatric Oncology, Laboratory for Clinical Medicine, Capital Medical University, Key Laboratory of Maior Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthMedical Oncology Department, Pediatric Oncology Center, National Key Clinical Discipline of Pediatric Oncology, Laboratory for Clinical Medicine, Capital Medical University, Key Laboratory of Maior Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthMedical Oncology Department, Pediatric Oncology Center, National Key Clinical Discipline of Pediatric Oncology, Laboratory for Clinical Medicine, Capital Medical University, Key Laboratory of Maior Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthMedical Oncology Department, Pediatric Oncology Center, National Key Clinical Discipline of Pediatric Oncology, Laboratory for Clinical Medicine, Capital Medical University, Key Laboratory of Maior Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthAbstract Objective The aim of the study was to describe the control of acute chemotherapy-induced nausea and vomiting (CINV) in children with solid tumors receiving highly emetogenic chemotherapy (HEC) at our center. Additionally, the study aimed to explore the risk factors for chemotherapy-induced vomiting (CIV) with the ultimate goal of enhancing CINV management for children. Methods Children aged 1–18 years with solid tumors treated with HEC were enrolled. A structured diary was used to record CINV data, and the pediatric nausea assessment tool (PeNAT) was employed to assess the degree of nausea. The primary outcome was achieving complete CIV control in the acute phase for all children, and secondary outcomes included the control of acute phase CINV, CIV, and chemotherapy-induced nausea (CIN) in children aged ≥ 4 years. Data on children were prospectively collected, and univariate and multivariate logistic regression was used to explore risk factors for complete CIV control. Results A total of 181 children were included, with 52.5% (95/181) experiencing acute phase complete CIV control. Eighty-six children aged ≥ 4 years could be evaluated for acute phase CINV control, and complete CINV control was achieved in 27.9% (24/86), with CIV, CIN complete control rates were 41.9% (36/86) and 34.9% (30/86), respectively. The results of multivariate logistic regression showed age (< 2 years vs. >6 years: OR = 0.186, 95% CI 0.062 ~ 0.56; 2 ~ 6 years vs. >6 years: OR = 0.322, 95% CI 0.145 ~ 0.715), female (OR = 2.034, 95% CI 1.035 ~ 3.994), duration of chemotherapy block (OR = 1.611, 95%CI 1.039 ~ 2.499), and antiemetic regimen (5-hydroxytryptamine-3 receptor antagonists (5HT3RA) vs. 5HT3RA + dexamethasone: OR = 0.395, 95% CI 0.171 ~ 0.914) were statistically significant in complete CIV control (P < 0.05). Conclusions Children with solid tumors treated with HEC at our center experienced suboptimal control of CINV. Older age, female, and a longer duration of the chemotherapy block were identified as risk factors for complete CIV control. Receipt of 5HT3RA plus dexamethasone had a higher likelihood of acute phase complete CIV control versus 5HT3RA. In the future, individualized management of nausea and vomiting, based on existing CINV guidelines and the unique characteristics of children, will be necessary to reduce the incidence of CINV and improve the quality of life for these children.https://doi.org/10.1186/s12887-025-05451-9ChildrenChemotherapyAcute phaseVomitingNauseaRisk factors
spellingShingle Miaomiao Shao
Ying Li
Jing Qin
Yuchen Zhou
Yixin Sun
Peiyi Yang
Xisi Wang
Cheng Huang
Yan Su
Wen Zhao
Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study
BMC Pediatrics
Children
Chemotherapy
Acute phase
Vomiting
Nausea
Risk factors
title Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study
title_full Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study
title_fullStr Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study
title_full_unstemmed Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study
title_short Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study
title_sort fact finding and risk factor analysis of chemotherapy induced nausea and vomiting in children with solid tumors a prospective observational study
topic Children
Chemotherapy
Acute phase
Vomiting
Nausea
Risk factors
url https://doi.org/10.1186/s12887-025-05451-9
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