Prevalence and Predictors of Acute Chemotherapy-induced Nausea and Vomiting Among Cervical Cancer Patients at Kenyatta National Hospital

Abstract

ABSTRACT Background Cervical cancer is a major public health concern affecting women of middle age, particularly in less-resourced countries. Chemotherapy is an integral part of its management. However, antineoplastic agents used cause severe nausea and emesis. Regardless of the many approaches to treat chemotherapy-induced nausea and vomiting, these symptoms remain a challenge. Objective To evaluate the prevalence and predictors of acute nausea and vomiting among cervical cancer patients receiving chemotherapy at Kenyatta National Hospital (KNH). Methodology A cross-sectional study among 98 cervical cancer patients receiving chemotherapy at the Cancer Treatment Centre of KNH. Research participants who gave informed consent were interviewed. The biodata, social demographic data, data on relevant clinical characteristics, and nausea and vomiting assessment data was collected. Additional information was extracted from the medical records. This included data on cervical cancer profiles, chemotherapy details, and antiemetic therapy details. Data analysis was done using descriptive and inferential statistics at a 0.05 level of significance. STATA version 17 software was used during the analysis. The socio-demographic, clinical characteristics and data on cervical cancer management were summarized using frequency distribution tables. . . The association between the prevalence of CINV and the socio-demographic, treatment, and clinical characteristics were determined using inferential statistics including the Pearson Chi-square and Fischer's exact test. To identify the independent risk factors for CINV, logistic regression was conducted using the backward stepwise elimination method. The level of significance was set at 0.05. Results The majority (83.7 % ) of the participants were middle-aged with a median age of 49 years [IQR = 41, 62]. Over half (53.3 %) of the patients were on chemotherapy alone. Platinum analogs were used in 97.8 % of the patients. A significant proportion (70.7 %) developed acute CINV. All the participants had prophylaxis against ACINV, and most (90 %) were on a 2-drug regimen. Anticipatory nausea and vomiting was found to be an independent predictor of ACINV [aOR = 4.685, 95 % CI: (1.227 - 17.89), p = 0.024]. The independent predictors of anticipatory nausea and vomiting included the stage of cancer [aOR = 0.386, 95 % CI: (0.164

– 0.911), p = 0.03]. and the use of additional modalities in management of cervical cancer [aOR = 4.462, 95 % CI: (1.134 – 17.553), p = 0.032] Conclusions The prevalence of acute chemotherapy induced nausea and vomiting among the cervical cancer patients receiving chemotherapy was high. The stage of cancer and use of additional modalities in the management of cervical cancer were identified as independent predictors of anticipatory CINV which was in turn found to be an independent predictor associated with increased risk of acute CINV