Purpose

Cisplatin-based chemoradiotherapy (CRT) is standard treatment for head and neck squamous cell carcinoma (HNSCC). However, IMRT may increase chemotherapy-induced nausea and vomiting (CINV). The purpose of this study is to investigate the effect of fosaprepitant in preventing CINV.

Methods

An infusion of 150 mg fosaprepitant was given through a 30 min. We assessed acute toxicity using CTCAE v.4 and the incidence of CINV using the FLIE questionnaire. The evaluation of CINV was done at the second and fifth weeks of CRT and 1 week after the end. The EORTC QLQ-HN 43 questionnaire was administered before treatment beginning (baseline), at second (T1) and fifth (T2) weeks. A dosimetric analysis was performed on dorsal nucleus of vagus (DVC) and area postrema (AP).

Results

Between March and November 2020, 24 patients were enrolled. No correlation was found between nausea and DVC mean dose (p = 0.573), and AP mean dose (p = 0.869). Based on the FLIE questionnaire, patients reported a mean score of 30.5 for nausea and 30 for vomiting during week 2 and 29.8 for nausea and 29.2 for vomiting during week 5. After treatment ended, the mean scores were 27.4 for nausea and 27.7 for vomiting. All patients completed the EORTC QLQ-HN 43. Significantly higher scores at T2 assessment than baseline were observed.

Conclusions

The use of fosaprepitant in preventing CINV reduced incidence of moderate to severe nausea and vomiting. No correlation has been found between nausea and median dose to DVC and AP.

中文翻译：

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福沙匹坦预防接受顺铂放化疗的头颈癌患者恶心和呕吐的影响：一项试点前瞻性研究和文献综述

目的

基于顺铂的放化疗 (CRT) 是头颈鳞状细胞癌 (HNSCC) 的标准治疗方法。然而，IMRT 可能会增加化疗引起的恶心和呕吐 (CINV)。本研究的目的是探讨福沙匹坦预防 CINV 的效果。

方法

30 分钟内输注 150 mg 福沙匹坦。我们使用 CTCAE v.4 评估急性毒性，并使用 FLIE 问卷评估 CINV 的发生率。 CINV的评估在CRT的第二周和第五周以及结束后1周进行。 EORTC QLQ-HN 43 问卷在治疗开始前（基线）、第二周 (T1) 和第五周 (T2) 进行。对迷走神经背核 (DVC) 和后区 (AP) 进行剂量分析。

结果

2020 年 3 月至 11 月期间，共有 24 名患者入组。恶心与 DVC 平均剂量 ( p  = 0.573) 和 AP 平均剂量 ( p  = 0.869)之间没有相关性。根据 FLIE 问卷，患者报告第 2 周恶心平均得分为 30.5，呕吐平均得分为 30，第 5 周恶心平均得分为 29.8，呕吐平均得分为 29.2。治疗结束后，恶心平均得分为 27.4，呕吐平均得分为 27.7。所有患者均完成了 EORTC QLQ-HN 43。观察到 T2 评估时的分数显着高于基线。

结论

使用福沙吡坦预防 CINV 可降低中度至重度恶心和呕吐的发生率。尚未发现恶心与 DVC 和 AP 中位剂量之间存在相关性。