Evaluation of the relation between patient characteristics and the state of chemotherapy-induced nausea and vomiting in patients with gynecologic cancer receiving paclitaxel and carboplatin

Arch Gynecol Obstet. 2014 Apr;289(4):859-64. doi: 10.1007/s00404-013-3058-7. Epub 2013 Nov 2.


Purpose: An antiemetic regimen for patients taking paclitaxel and carboplatin (TC) includes dexamethasone (20 mg) to protect against hypersensitivity. Chemotherapy-induced nausea and vomiting (CINV), however, is difficult to adequately control in patients receiving TC. In the present study, we retrospectively investigated risk factors for CINV in patients receiving TC with this antiemetic regimen based on a questionnaire.

Methods: Eligible patients were diagnosed with gynecologic cancer and receiving paclitaxel (175 mg/m(2)) intravenously for 3 h and carboplatin (area under the curve 5 mg/mL per min) on day 1 every 3 weeks in our institution, and treated with granisetron (3 mg) and dexamethasone (20 mg) for antiemesis. Data of nausea and vomiting assessed by Common Terminology Criteria for Adverse Events version4.0 were collected from the medical records. Patients were asked to complete a questionnaire including items such as age and hyperemesis. Logistic regression analysis was used to evaluate univariate and independent multivariate associations with items on nausea of grade 2 or greater and vomiting of grade 1 or greater.

Results: On univariate logistic analysis, no item was significantly associated with nausea of grade 2 or greater. Hypertension and hyperemesis gravidarum and adjuvant chemotherapy were significantly associated with delayed vomiting of grade 1 or greater. Multivariate analysis was performed with delayed vomiting of grade 1 or greater as an endpoint, and the resulting independent items were hypertension and hyperemesis gravidarum.

Conclusions: The present study showed that the risk factor for delayed vomiting of grade 1 or higher was a history of hyperemesis gravidarum in patients receiving conventional TC with dexamethasone (20 mg) and granisetron. Therefore, in patients with this risk factor, criteria of major organizations should be followed first.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiemetics / therapeutic use
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Carboplatin / administration & dosage
  • Carboplatin / adverse effects*
  • Dexamethasone / therapeutic use
  • Female
  • Genital Neoplasms, Female / drug therapy*
  • Granisetron / therapeutic use
  • Humans
  • Hyperemesis Gravidarum / epidemiology
  • Hypertension / epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Nausea / chemically induced*
  • Nausea / drug therapy
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects*
  • Pregnancy
  • Retrospective Studies
  • Surveys and Questionnaires
  • Vomiting / chemically induced*
  • Vomiting / drug therapy


  • Antiemetics
  • Antineoplastic Agents
  • Dexamethasone
  • Carboplatin
  • Paclitaxel
  • Granisetron