Establishment of an antiemetic protocol for chemotherapy-induced nausea and vomiting evaluated using the Multinational Association of Supportive Care in Cancer Antiemesis Tool in colorectal cancer

This study aimed to evaluate the frequency and extent of chemotherapy-induced nausea and vomiting (CINV) in patients with colorectal cancer (CRC) who underwent chemotherapy, using the Multinational Association of Supportive Care in Cancer (MASCC) Antiemesis Tool (MAT), and establish an antiemetic protocol for the management of CINV, independent of the treating oncologist. We conducted a prospective observational study from October 2017 to June 2018 at the Higashihiroshima Medical Center. Patients who had undergone moderate CINV risk chemotherapy for CRC were eligible. The incidence of CINV was evaluated using the MAT, and medical prophylaxis was gradually provided following the antiemetic protocol. We enrolled 30 patients, and 27 of 30 patients (90%) were assessed more than once using the MAT. Among these 27 patients, the incidence of acute nausea was 30% and delayed nausea was 26% as evaluated using the MAT based on recommended pharmacological prophylaxis guidelines. Between the start and end of the survey, there was no significant difference in the numeric rating scale (NRS) score for acute nausea, but there was a significant reduction in the NRS score for delayed nausea. The clinical significance of the antiemetic protocol as assessed using the MAT in reducing CINV was demonstrated. The clinical use of the protocol may help in the realization that selective pharmacological prophylaxis for patients with CINV is possible, independent of the treating oncologist.