がん化学療法による悪心・嘔吐発現の性差

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Prevention of adverse effects is an important aspect of cancer chemotherapy. In this regard, nausea and vomiting induced by chemotherapy are limiting factors in patients' activities of daily living. As it has been reported that gender is a risk factor for emesis in other countries, we investigated the relationship between gender and the incidence of nausea and vomiting in Japanese outpatients receiving cancer chemotherapy. Our subjects were 70 male patients and 47 female patients receiving 6 regimens of chemotherapy at the Outpatient Oncology Unit of Kyoto University Hospital in 2005, for which the risk of acute emesis was over 90%. We studied the incidence of chemotherapy-induced emesis and evaluated its severity using the Common Terminology Criteria for Adverse Events v.3.0. Though almost all patients received dexamethasone and 5-HT_3 serotonin receptor antagonists, the incidence of nausea with grade 2 or higher in female and male patients was 23.4% and 2.9%, respectively, and the incidence of vomiting in female and male patients was 25.5% and 5.7%, respectively. We examined these results by means of logistic regression analysis with adjustments for age and history prior to chemotherapy to see if there was an association between chemotherapy-induced emesis and gender. The findings indicated that woman had a higher incidence of emesis than man with adjusted odds ratios of 8.77 for nausea (95% confidence intervals 1.71-44.95) and 3.26 for vomiting (95% confidence intervals 0.90-11.77). This suggests that being female is a predictive factor of poor antiemetic control in Japanese patients and information on such predictive factors for adverse reactions should be useful to clinical pharmacists in conducting cancer chemotherapy more safely.
日本医療薬学会の論文
2008-08-10

がん化学療法による悪心・嘔吐発現の性差

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