EFFECT OF POSTCHEMOTHERAPY NAUSEA AND VOMITING ON HEALTH-RELATED QUALITY-OF-LIFE

The purpose was to measure the effects of postchemotherapy nausea and vomiting (PCNV) on health-related quality of life (HQL) in patients re ceiving either moderately or highly emetogenic chemotherapy. The study sample consisted of 832 chemotherapy-naive patients with cancer who r eceived either moderately or highly emetogenic chemotherapy as part of multicenter trials of new antiemetics, The patients completed the sel f-report European Organization for Research and Cancer (EORTC:) core Q uality of Life Questionnaire (QLQ-C30) before chemotherapy (baseline) and 1 week (day 8) and 2-4 weeks after chemotherapy. They also complet ed a self-report nausea and vomiting (NV) diary for 5-7 days after che motherapy. To determine the effects of PCNV on HQL, the change in scor es between the baseline and day 8 HQL assessments was calculated for e ach domain and symptom in the QLQ-C30 and compared in four subgroups o f patients: those with both nausea and vomiting, those with nausea but no vomiting, those with no nausea but with vomiting, and those with n either nausea nor vomiting. The group with both nausea and vomiting sh owed statistically significantly worse physical, cognitive and social functioning, global quality of life, fatigue, anorexia, insomnia and d yspnea as compared to the group with neither nausea nor vomiting (0.00 01 < P < 0.05), Patients with only nausea but no vomiting tended to ha ve less worsening in functioning and symptoms than those having both n ausea and vomiting, Increased severity of vomiting (> 2 episodes) was associated with worsening of only global quality of life and anorexia as compared with 1-2 episodes of vomiting (0.0001 < P < 0.01), By 2-4 weeks after chemotherapy all HQL scores had either returned to their b aseline levels or were better than baseline, PCNV adversely affects se veral quality-of-life domains, but patients with only nausea experienc e less disruption than do those with both nausea and vomiting, Patient s with 1-2 episodes of vomiting experience almost the same degree of d isruption of HQL as do patients with more than 2 episodes of vomiting.