IMPACT OF TUMOR BURDEN ON CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING

We investigated how residual tumour burden after cytoreductive surgery was related to the occurrence of acute and delayed nausea and vomitin g in 101 ovarian cancer patients receiving their first chemotherapy co urse. The anti-emetic treatment included ondansetron combined with dex amethasone or placebo. After chemotherapy all patients received ondans etron only for 5 days. Two categories of tumour burden (TB) were forme d according to the diameter of the greatest residual tumour (< 2 cm = minimal TB and greater than or equal to 2 cm = large TB). Self-reports of nausea and vomiting were obtained for 15 days. Other potential pre dictor variables were assessed and included in multivariate analyses. Patients with large compared with minimal TB had more delayed emesis, especially on days 2-7. They also had more acute nausea. The aggravati ng effect associated with large residual TB was more evident in patien ts greater than or equal to 55 years. During the second week after the chemotherapy the occurrence of nausea was higher in patients greater than or equal to 55 years than in those <55 years. This was seen prima rily in patients with large residual TB. Predictors for no delayed eme sis at all were anti-emetic treatment with dexamethasone, minimal tumo ur burden, low neuroticism and no history of motion sickness. The incr eased risk of 'persistent' delayed nausea and vomiting seen in older p atients with large tumour burden may have important clinical implicati ons and warrants further attention.